WOODWARD DETROIT CVS LLC (NPI# 1245252915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245252915 |
| Entity Type | Organization |
| Organization Name | WOODWARD DETROIT CVS LLC |
| Other Organization Name | CVS PHARMACY #16674 |
| Practice Address |
3250 Us Highway 41 W Marquette MI 49855-9483 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 9062260095 |
| Practice Fax Number | 9062260095 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-07-24 |
| 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 |
5301010854 | MI | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2045503 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #16674 | 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 |
3250 US HIGHWAY 41 W |
| City | MARQUETTE |
| State | MI |
| Zip Code | 49855-9483 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528699451 | Ruffa Villota | Pharmacist | 3250 Us Highway 41 W, Marquette, MI 49855-9483 | 2020-01-29 |
| 1417300989 | Jaclyn Skradski | Pharmacist | 3250 Us Highway 41 W, Marquette, MI 49855-9483 | 2016-07-19 |
| 1972992402 | Stephen A Baranec | Pharmacist | 3250 Us Highway 41 W, Marquette, MI 49855-9483 | 2015-01-21 |
| 1669860342 | Matt Beachnau | Pharmacist | 3250 Us Highway 41 W, Marquette, MI 49855-9483 | 2015-01-02 |
| 1194010447 | Nichole Marie Munson | Pharmacist | 3250 Us Highway 41 W, T1334, Marquette, MI 49855-9483 | 2011-06-15 |
| 1730473554 | Cheri Johnson | Pharmacist | 3250 Us Highway 41 W, 1334, Marquette, MI 49855-9483 | 2011-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023665064 | Scott Allen Poirier | Physician Assistant | 850 West Baraga Avenue, Marquette, MI 49855 | 2019-08-23 |
| 1730734831 | Katelyn Tourville | Physician Assistant | 1401 Presque Isle Ave-health Center, Marquette, MI 49855 | 2019-08-06 |
| 1932681095 | Katelyn Longanbach | Physical Therapist | 841 W Washington St Ste 500, Marquette, MI 49855 | 2018-09-05 |
| 1366943979 | Meijer, Inc. | Durable Medical Equipment & Medical Supplies | 3630 Us 41 W, Marquette, MI 49855 | 2018-02-28 |
| 1518466143 | Orthopaedic Surgery Associates of Marquette PC | Prosthetic/Orthotic Supplier | 841 West Washington Street, Suite 100, Marquette, MI 49855 | 2018-02-09 |
| 1376075598 | Pamela Baynton | Licensed Practical Nurse | 2292 U.S. 41 W, Marquette, MI 49855 | 2017-03-28 |
| 1548709454 | Allison Jean Czarny | Registered Nurse | 160 E Wright Pl, Marquette, MI 49855 | 2017-02-13 |
| 1629427299 | Larry Chappel | Social Worker | 210 Chippewa Square, Suite 208, Marquette, MI 49855 | 2016-06-06 |
| 1366898348 | Carla Pate | Student in an Organized Health Care Education/Training Program | 235 Hunt Hall, Marquette, MI 49855 | 2016-05-10 |
| 1922479732 | Nicholas Wujcik | Student in an Organized Health Care Education/Training Program | 504 S Fifth St, Marquette, MI 49855 | 2015-10-20 |
| Find all providers in zip 49855 | ||||
| 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 |
|---|---|---|---|---|
| 1952704843 | State of Michigan | Pharmacy | 425 Fisher St, Marquette, MI 49855-4521 | 2014-10-06 |
| 1487665725 | Northern Michigan University | Pharmacy | 1401 Presque Isle Ave, Marquette, MI 49855-2818 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961763 | Dustyn Daniel Thoney | Pharmacy | 530 Harding Ave, Iron River, MI 49935-2265 | 2020-10-27 |
| 1497355697 | Katherine Jane Cybulski | Pharmacy | 1310 Waukazoo St, Hastings, MI 49058-9559 | 2020-10-27 |
| 1043836042 | Hanan Pharmacy LLC | Pharmacy | 4600 E 14 Mile Road, Suite 2, Warren, MI 48092-1057 | 2020-06-25 |
| 1770104192 | Hazelwood Pharmacy LLC | Pharmacy | 624 E 9 Mile Rd Ste C, Hazel Park, MI 48030-1842 | 2020-04-27 |
| 1457980609 | Berkley Pharmacy LLC | Pharmacy | 28577 Schoenherr Road, Warren, MI 48088 | 2020-04-08 |
| 1669012316 | Warriors Pharmacy, Inc. | Pharmacy | 5265 Anthony Wayne Dr, Detroit, MI 48202-3947 | 2020-01-10 |
| 1457996662 | Sunrise Pharmacy, LLC | Pharmacy | 989 University Dr Ste 104, Pontiac, MI 48342-1885 | 2019-11-12 |
| 1447894019 | Nova Pharmacy | Pharmacy | 15140 Levan Rd, Suite 40, Livonia, MI 48154 | 2019-11-06 |
| 1912541673 | Wayne Pharma | Pharmacy | 974 Ford Ave, Wyandotte, MI 48192 | 2019-11-05 |
| 1639720667 | Grand Haven Pharmacy LLC | Pharmacy | 930 John R Rd Ste Pharmacy, Troy, MI 48083-4316 | 2019-09-20 |
| Find all providers with the same taxonomy | ||||
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| 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.