WOODWARD DETROIT CVS LLC (NPI# 1235152513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235152513 |
| Entity Type | Organization |
| Organization Name | WOODWARD DETROIT CVS LLC |
| Other Organization Name | CVS PHARMACY #17107 |
| Practice Address |
5120 28th St Se Grand Rapids MI 49512-2049 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 6162224890 |
| Practice Fax Number | 6162224890 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2016-09-28 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301010859 | MI | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2044254 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #17107 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093181943 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 2506 Niles Ave, Saint Joseph, MI 49085-1924 | 2015-08-14 |
| 1902292881 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 1015 S Saginaw Rd, Midland, MI 48640-5642 | 2015-04-08 |
| 1386992204 | Woodward Detroit Cvs LLC | Pharmacy | 626 West Front St, Traverse City, MI 49684-2210 | 2012-08-27 |
| 1073748000 | Woodward Detroit Cvs LLC | Pharmacy | 28800 Dequindre Rd, Warren, MI 48092-2466 | 2009-05-20 |
| 1619125069 | Woodward Detroit Cvs LLC | Pharmacy | 20877 Hall Rd, Macomb, MI 48044-4256 | 2008-08-28 |
| 1528216975 | Woodward Detroit Cvs LLC | Pharmacy | 2400 S Telegraph Rd, Bloomfield Hills, MI 48302-0255 | 2008-08-28 |
| 1508042524 | Woodward Detroit Cvs LLC | Pharmacy | 47330 Michigan Ave, Canton, MI 48188-2582 | 2008-01-22 |
| 1417141482 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 5057 Harvey St, Norton Shores, MI 49444-9795 | 2007-08-31 |
| 1760532089 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 5350 W Main St, Kalamazoo, MI 49009-3304 | 2007-01-11 |
| 1619027950 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 2310 Metropolitan Pkwy, Sterling Heights, MI 48310-4209 | 2007-01-11 |
| Street Address |
5120 28TH ST SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49512-2049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114478161 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5120 28th St Se, Grand Rapids, MI 49512-2049 | 2016-10-14 |
| 1790182178 | David Duy Tran | Pharmacist | 5120 28th St Se, Grand Rapids, MI 49512-2049 | 2014-12-01 |
| 1023440815 | Janelle Kaye Turino | Pharmacist | 5120 28th St Se, Grand Rapids, MI 49512-2049 | 2013-08-02 |
| 1356690960 | Michelle A Crane | Pharmacist | 5120 28th St Se, Grand Rapids, MI 49512-2049 | 2012-08-29 |
| 1932494598 | Daniel S Sheputis | Pharmacist | 5120 28th St Se, T-2014, Grand Rapids, MI 49512-2049 | 2011-06-12 |
| 1720372642 | Laura Leipham | Pharmacist | 5120 28th St Se, Grand Rapids, MI 49512-2049 | 2011-06-08 |
| 1497049787 | Kristan Lee Wittig | Pharmacist | 5120 28th St Se, Grand Rapids, MI 49512-2049 | 2011-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649757071 | St. Lukes Primary Care | Family Medicine | 5300 Patterson Ave Se Ste 1-d, Grand Rapids, MI 49512 | 2018-07-27 |
| 1013493733 | Pharmascript of Michigan Gr LLC | Pharmacy | 2661 29th St. Se Suite A, Grand Rapids, MI 49512 | 2018-07-16 |
| 1245736040 | Cassandra Slater | Technician, Other | 2925 Breton Rd Se, Grand Rapids, MI 49512 | 2018-04-02 |
| 1235632704 | John Mitchell Tanja | Occupational Therapist | 3350 Broadmoor Avenue Se, Grand Rapids, MI 49512 | 2018-03-12 |
| 1952829855 | Sarah Harlow | Physical Therapist | 2951 44th St Se, Kentwood, MI 49512 | 2017-08-31 |
| 1194248815 | Melinda Huizenga | Registered Nurse | 5300 Patterson Ave Se Ste 125, Grand Rapids, MI 49512 | 2017-07-25 |
| 1659812931 | Frantzie Pierre | Counselor | 3300 S Creek Dr Se Apt 201, Kentwood, MI 49512 | 2017-03-20 |
| 1104128602 | Hope Network Behavioral Health Services | Psychiatry & Neurology | 3361 36th Street, Grand Rapids, MI 49512 | 2010-12-03 |
| 1518282631 | Melanie Anne Hogeterp | Social Worker | 3180 East Paris Se, Kentwood, MI 49512 | 2010-03-31 |
| 1013147495 | Ardean Beth Brock-vanderwall | Counselor | 2828 Kraft Ave., Grand Rapids, MI 49512 | 2009-07-20 |
| Find all providers in zip 49512 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447746508 | Vincent Albert Patchett | Pharmacy | 800 Leonard St Nw Apt 115, Grand Rapids, MI 49504-4148 | 2018-07-02 |
| 1700321551 | Trinity Health-michigan | Pharmacy | 360 Division Ave S Ste 1e, Grand Rapids, MI 49503-4501 | 2017-01-04 |
| 1447668843 | Cet Pharmacy Ltc LLC | Pharmacy | 6140 28th St Se Ste 105, Grand Rapids, MI 49546-6938 | 2014-07-29 |
| 1588963706 | Ltc Pharmacy LLC | Pharmacy | 1314 Leonard St Nw, Grand Rapids, MI 49504-2937 | 2011-03-28 |
| 1225352909 | Kentwood Pharmacy LLC | Pharmacy | 2026 Boston St. Se, Grand Rapids, MI 49506 | 2010-03-24 |
| 1285963611 | Great Lakes Rph Corp | Pharmacy | 2500 E Beltline Ave Se Ste O, Grand Rapids, MI 49546-5987 | 2009-12-14 |
| 1083752075 | J & L Urevig Inc | Pharmacy | 124 Ne 4th St, Grand Rapids, MN 55744-2840 | 2007-02-02 |
| 1093704371 | Fulton Pharmacy Inc | Pharmacy | 738 W Fulton St, Grand Rapids, MI 49504-6320 | 2005-10-19 |
| 1790391613 | Mohamad Sheikh-khalil | Pharmacy | 550 Cherry St Se, Grand Rapids, MI 49503-4748 | 2020-09-16 |
| 1902379159 | Grand Itasca Clinic and Hospital | Pharmacy | 1601 Golf Course Rd, Grand Rapids, MN 55744-8648 | 2019-01-09 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49512 |
Please comment or provide details below to improve the information on WOODWARD DETROIT CVS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.