PINE KNOB PHARMACY 4 INC (NPI# 1255449625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255449625 |
| Entity Type | Organization |
| Organization Name | PINE KNOB PHARMACY 4 INC |
| Other Organization Name | PINE KNOB SAVMOR PHARMACY 4 |
| Practice Address |
5710 Bella Rosa Blvd Clarkston MI 48348-4773 |
| Mailing Address |
43155 W 9 Mile Rd Novi MI 48375-4190 |
| Practice Telephone | 2486200296 |
| Practice Fax Number | 2486747436 |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2008-04-15 |
| Authorized Official Name | STEPHEN GRAHAM (MANAGER PHARMACY SERVICES) |
| Authorized Official Telephone | 2483481570 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301006722 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2357728 | 05 | |
| OTHER ID NUMBER | 2357728 | 01 |
| Other Name | Type Code |
|---|---|
| PINE KNOB SAVMOR PHARMACY 4 | Doing Business As Name - Organization |
| Street Address |
5710 BELLA ROSA BLVD |
| City | CLARKSTON |
| State | MI |
| Zip Code | 48348-4773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699000174 | Vikas R Soni | Physical Therapist | 5710 Bella Rosa Blvd, Suite # 300, Clarkston, MI 48348-4773 | 2009-10-16 |
| 1629256169 | Pine Knob Pharmacy #4 | Durable Medical Equipment & Medical Supplies | 5710 Bella Rosa Blvd, Clarkston, MI 48348-4773 | 2008-02-06 |
| 1154410975 | Daniel Mccoskey | Pharmacist | 5710 Bella Rosa Blvd, Clarkston, MI 48348-4773 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548100 | Grey Street Counseling and Wellness Center, LLC | Counselor | 314 Moonlite Court, Clarkston, MI 48348 | 2020-11-06 |
| 1134787906 | Claudia Maryann Beauvais | Peer Specialist | 4533 Sedona Dr, Clarkston, MI 48348 | 2019-06-05 |
| 1669965299 | Wellbridge of Clarkston, LLC | Skilled Nursing Facility | 5655 Clarkston Road, Independence Township, MI 48348 | 2018-06-08 |
| 1164794251 | Kong C. Choi | Family Medicine | 8324 Caribou Trl., Clarkston, MI 48348 | 2012-02-03 |
| 1447587753 | Carrie Ann Schlicht | Occupational Therapist | 7508 Mecad Boulevard, Suite A, Clarkston, MI 48348 | 2009-11-06 |
| 1740424290 | Nedra Gean Downing | General Practice | 5715 Bella Rose Blvd., Ste 100, Clarkston, MI 48348 | 2009-04-28 |
| 1467600528 | Brian Davidson Dds PC | Dentist | 5720 Clarkston Road, Clarkston, MI 48348 | 2008-09-03 |
| 1962624957 | Keri Sue Hickmott | Social Worker | 9340 Dixie Highway, Clarkston, MI 48348 | 2007-05-02 |
| 1720209273 | Linda Carole Gualdoni | Physical Therapist | 7508 M.e. Cad Blvd., Suite A, Clarkston, MI 48348 | 2007-05-01 |
| 1396964466 | David William Regiani | Dentist | 10435 Ortonville Road, Suite B, Clarkston, MI 48348 | 2007-04-25 |
| Find all providers in zip 48348 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225375603 | Zak Pharmacy LLC. | Pharmacy | 4600 E Ponce De Leon Ave Ste E, Clarkston, GA 30021-1839 | 2013-01-06 |
| 1598040271 | Walgreen Co | Pharmacy | 7110 Dixie Hwy., Clarkston, MI 48371 | 2011-10-13 |
| 1144429952 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 5756 Clarkston Rd, Clarkston, MI 48348-4706 | 2007-07-12 |
| 1245300797 | Clarkston Heights Pharmacy | Pharmacy | 2119 5th Ave, Clarkston, WA 99403-1406 | 2006-11-09 |
| 1174625453 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 5529 Sashabaw Rd, Clarkston, MI 48346-3147 | 2006-09-05 |
| 1346352283 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 7091 Dixie Hwy, Clarkston, MI 48346-2076 | 2006-08-31 |
| 1891803268 | Pine Knob Pharmacy #3, Inc. | Pharmacy | 6770 Dixie Highway, Suite 201, Clarkston, MI 48346 | 2006-08-27 |
| 1811902943 | Walgreen Co | Pharmacy | 7110 Dixie Hwy, Clarkston, MI 48346-2014 | 2006-07-29 |
| 1679509251 | U.n. Pharmcay | Pharmacy | 3652 Market St, Unit C-1, Clarkston, GA 30021-1298 | 2006-06-24 |
| 1679569362 | Clarkstonrx LLC | Pharmacy | 5838 S Main St, Clarkston, MI 48346-2963 | 2005-09-27 |
| Find all providers in CLARKSTON | ||||
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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.