Individual provider Active NPI

Jeanne Quintern, RPH

  • Pharmacist
  • Grand Island, NY
National Provider Identifier
1972782720
Registry record updated Jul 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
042102 Issued in NY
Practice address
2325 Grand Island Blvd
Grand Island, NY 14072
Phone
(716) 773-1724
Fax
(716) 775-1336
NPI assigned
Oct 29, 2007
Last updated
Jul 15, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 042102 NY Primary

Addresses

Primary practice location

2325 Grand Island Blvd
Grand Island, NY 14072

Mailing address

2325 Grand Island Blvd
Grand Island, NY 14072
Phone (716) 773-1724

Other identifiers 1

IdentifierTypeStateIssuer
01426219MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
042102NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Eckerd Corporation Past Accepting new patients
Eckerd Corporation Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1972782720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 GRAND ISLAND BLVD",
            "city": "GRAND ISLAND",
            "state": "NY",
            "postal_code": "14072",
            "telephone_number": "716-773-1724",
            "fax_number": "716-775-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 GRAND ISLAND BLVD",
            "city": "GRAND ISLAND",
            "state": "NY",
            "postal_code": "14072",
            "telephone_number": "716-773-1724",
            "fax_number": "716-775-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTERN",
        "first_name": "JEANNE",
        "name_prefix": "Miss",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-29",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "042102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01426219",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.