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Created By/On: Devel# 11/26/2015 | 5:23:47 AM

Maintained By/On: Jayden Smith 02/12/2018 | 5:06:479 AM

Prescriber Addresses

Prescriber Name : Currie Kim S

NPI : 1255541603

Pri Pri	Type Type	Address 1 Address 1	Address 2 Address 2	City City	State State	ZIP ZIP
Y		1022 2nd St		Columbus	NE	68601
N	340B	715 Shepherd	Hollow Rd		TN	37079
Y		2349 Spinnaker Lane		Joliet	IL	60432
Y		3015 Green Avenue		Oakland	CA	94612
Y		1566 Elm Drive		Cambridge	NY	12816
N		932 Deer Haven Drive		Greenville	SC	29607

Keep

Pri Pri	Type Type	Address 1 Address 1	Address 2 Address 2	City City	State State	ZIP ZIP
N		289 Franklin Street		Montgomery	AL	36014

Delete

Pri Pri	Type Type	Address 1 Address 1	Address 2 Address 2	City City	State State	ZIP ZIP
N		3658 Poplar Street		Park Forest	IL	60466

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City

State

ZIP

Name Name	NPI NPI	SPI Number SPI Number	NCPDP NCPDP	DEA DEA	Address Address	Type Type	City City	State State	ZIP ZIP	Phone Phone	Status Status
Johnson James	1700994597	MA0910085	3200994329	2800994137	88 Center Rd	340B	Bedford	OH	44146	715-361-4850	Active
Annie Wiedman	1700994124	MA0910302	3200995321	2800996247	3546 Smith Road	749B	Acworth	GA	30101	770-917-8863	Active
Dave Mustaine	1700994124	MA0910302	3200995321	2800996247	1838 Morningview Lane	829B	New York	NY	10013	646-202-3632	Active
Earl Renner	1700994124	MA0910302	3200995321	2800996247	2051 Marion Street	627B	Columbia	SC	29201	803-231-2767	Active
Jenny Lewis	1700994124	MA0910302	3200995321	2800996247	2582 Pearl Street	380B	Burlington	KY	41005	655-729-9638	Active
Paul McCartney	1700994124	MA0910302	3200995321	2800996247	3831 Formula Lane	270B	Dallas	TX	75234	469-556-1365	Active

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DEA

NPI

Phone

State

Name	DEA#	NPI#	Address	City	State	ZIP	Phone	Service Lavel
Aldrich, Jose	MA0910085	1700994597	88 Center Rd	Bedford	OH	44146	715-361-4850	New Rxs, Refill