COUNTRY SQUIRE DISCOUNT PHARMACY, INC (NPI# 1265445936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265445936 |
| Entity Type | Organization |
| Organization Name | COUNTRY SQUIRE DISCOUNT PHARMACY, INC |
| Other Organization Name | COUNTRY SQUIRE PHARMACY |
| Practice Address |
30 E Main St Fremont MI 49412-1244 |
| Practice Telephone | 2319242120 |
| Practice Fax Number | 2319246310 |
| Mailing Telephone | 2319242120 |
| Mailing Fax Number | 2319246310 |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2014-07-28 |
| Authorized Official Name | JUDSON AFMAN (PRESIDENT) |
| Authorized Official Telephone | 2319242120 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301001172 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1878530 | 05 | |
| PK | 2039663 | 01 |
| Other Name | Type Code |
|---|---|
| COUNTRY SQUIRE PHARMACY | Doing Business As Name - Organization |
| Street Address |
30 E MAIN ST |
| City | FREMONT |
| State | MI |
| Zip Code | 49412-1244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083615504 | Judson K Afman | Pharmacist | 30 E Main St, Fremont, MI 49412-1244 | 2005-08-09 |
| 1952645582 | John William Carlson Jr. | Pharmacist | 30 E Main St, Fremont, MI 49412-1244 | 2012-11-20 |
| 1346484375 | Jeanne Louise Feikema | Pharmacist | 30 E Main St, Fremont, MI 49412-1244 | 2009-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437632437 | Claire Marie J Derks | Massage Therapist | 119 North Stone Road, Fremont, MI 49412 | 2018-09-14 |
| 1730565946 | Retirement Living Management of Fremont, L.L.C. | Assisted Living Facility | 801 E. Main Street, Fremont, MI 49412 | 2015-08-11 |
| 1497136410 | James Yon | Social Worker | 3682 S Maple Island Rd, Fremont, MI 49412 | 2015-06-16 |
| 1871864090 | Cheryl Lee Kublin | Specialist | 4554 W. 48th St, Fremont, MI 49412 | 2012-01-19 |
| 1326319583 | Colleen M Rice | Occupational Therapist | 4554 W. 48th Street, Fremont, MI 49412 | 2012-01-19 |
| 1154578847 | Greenlund Enterprises, Inc | Hearing Aid Equipment | 28 Wet Sheridan Street, Fremont, MI 49412 | 2008-08-25 |
| 1225170699 | Raymond Prins IIi | Dentist | 855 N Darling, Fremont, MI 49412 | 2007-02-13 |
| 1508933789 | Charles Merle Erickson | Dentist | 16 W Sheridan, Fremont, MI 49412 | 2006-11-30 |
| 1588741300 | Christopher Callis Niquette | Dentist | 327 Apache Dr, Fremont, MI 49412 | 2006-11-01 |
| 1417041179 | Newaygo County Resa | Local Education Agency (LEA) | 4747 W. 48th Street, Fremont, MI 49412 | 2006-10-03 |
| Find all providers in zip 49412 | ||||
| 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] |
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| 1770681827 | Grund Drug Co | Pharmacy | 227 S. Front St, Fremont, OH 43420 | 2006-09-20 |
| 1437261443 | Lewton and Assoc Health Care Service | Pharmacy | 824 W State St, Fremont, OH 43420-2538 | 2006-08-31 |
| 1548203862 | Longs Drug Stores California LLC | Pharmacy | 46445 Mission Blvd, Fremont, CA 94539-7909 | 2006-06-14 |
| 1881637676 | Longs Drug Stores California LLC | Pharmacy | 4020 Fremont Hub, Fremont, CA 94538-1322 | 2006-06-13 |
| 1609818426 | Longs Drug Stores California LLC | Pharmacy | 35720 Fremont Blvd, Fremont, CA 94536-3421 | 2006-06-13 |
| 1316498421 | Pansmart Inc | Pharmacy | 2557 Mowry Ave, Suite # 11, Fremont, CA 94538-1603 | 2016-10-24 |
| 1356699722 | Mowry Plaza Pharmacy Inc | Pharmacy | 668 Mowry Ave, Fremont, CA 94536-4113 | 2012-08-16 |
| 1518249432 | Walgreens | Pharmacy | 2600 Mowry Ave, Fremont, CA 94538-1619 | 2011-09-16 |
| 1891839965 | Save Mart Supermarkets | Pharmacy | 5000 Mowry Ave, Fremont, CA 94538-1045 | 2007-02-20 |
| Find all providers in FREMONT | ||||
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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.