CENTRAL PHARMACY-MATTAWAN LLC (NPI# 1356571988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356571988 |
| Entity Type | Organization |
| Organization Name | CENTRAL PHARMACY-MATTAWAN LLC |
| Other Organization Name | MEDICINE TREE PHARMACY |
| Practice Address |
56109 Village Center Cir Mattawan MI 49071-8368 |
| Practice Telephone | 2696686801 |
| Practice Fax Number | 2696686802 |
| Mailing Telephone | 2696686801 |
| Mailing Fax Number | 2696686802 |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2018-06-27 |
| Authorized Official Name | MR. KRISHNA KANDAGATLA (MEMBER) |
| Authorized Official Telephone | 2696686801 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301009144 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2121009 | 01 |
| Other Name | Type Code |
|---|---|
| Medicine Tree Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811468614 | Central Pharmacy-mattawan LLC | Pharmacy | 56109 Village Center Cir, Mattawan, MI 49071-8368 | 2018-12-06 |
| Street Address |
56109 VILLAGE CENTER CIR |
| City | MATTAWAN |
| State | MI |
| Zip Code | 49071-8368 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528521036 | Timothy James Sassin | Pharmacist | 56109 Village Center Cir, Mattawan, MI 49071-8368 | 2019-04-11 |
| 1811468614 | Central Pharmacy-mattawan LLC | Pharmacy | 56109 Village Center Cir, Mattawan, MI 49071-8368 | 2018-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235617598 | Sheryl Ann Miller | Psychologist | 8570 Pq Avenue, Mattawan, MI 49071 | 2018-07-30 |
| 1568997054 | Willow Path Counseling Services | Community/Behavioral Health | 8089 Stadium Drive, Suite A, Kalamazoo, MI 49071 | 2017-04-22 |
| 1154508596 | Red Cedar Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 50762 Kiawah Trail, Suite B, Mattawan, MI 49071 | 2008-01-29 |
| 1639214794 | Rebecca Carr | Speech-Language Pathologist | 22899 Weather Vane Ct, Mattawan, MI 49071 | 2007-02-20 |
| 1891898730 | Edward I Porter | Counselor | 5500 Armstrong Road, Battle Creek Vamc, Battle Creek, MI 49071 | 2006-09-06 |
| 1376655365 | Mattawan Pharmacy | Pharmacy | 52366 N Main St, Mattawan, MI 49071-0069 | 2006-08-31 |
| 1164812491 | Sarah Mohney | Specialist/Technologist | 26402 Trestle Creek Ave, Mattawan, MI 49071-7713 | 2015-01-26 |
| 1114071487 | Shannon L Logsdon | Physical Therapist | 23200 Red Arrow Hwy Ste A, Mattawan, MI 49071-7754 | 2007-01-23 |
| 1447346036 | Kevin James Lacey | Physical Therapist | 23200 Red Arrow Hwy, A, Mattawan, MI 49071-7754 | 2006-10-04 |
| 1780002014 | Melissa Hulbert | Dental Hygienist | 23200 Red Arrow Hwy, Mattawan, MI 49071-7754 | 2014-04-03 |
| Find all providers in zip 49071 | ||||
| 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 |
|---|---|---|---|---|
| 1730327784 | Afav Enterprises LLC | Pharmacy | 52366 N Main St, Mattawan, MI 49071-9332 | 2009-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477389 | Rose Rex LLC | Pharmacy | 2330 S Milford Rd Ste 114, Highland, MI 48357-4982 | 2020-11-08 |
| 1508466194 | Grand Gratiot Pharmacy, LLC | Pharmacy | 7011 Gratiot Ave Ste 100, Detroit, MI 48207-1973 | 2020-10-31 |
| 1104424530 | Advance Care Rx, LLC | Pharmacy | 500 N Cass St, Berrien Springs, MI 49103-1069 | 2020-10-16 |
| 1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
| 1881292001 | Healthwatch Pharmacy Inc | Pharmacy | 1375 S Lapeer Rd Ste 102, Lake Orion, MI 48360-1421 | 2020-10-09 |
| 1225645781 | Good Choice Pharmacy LLC | Pharmacy | 6750 E 10 Mile Rd, Center Line, MI 48015-1166 | 2020-09-29 |
| 1487269122 | Canfield Pharmacy LLC | Pharmacy | 4673 Conner St, Detroit, MI 48215-2028 | 2020-09-10 |
| 1851905707 | Skidway Pharmacy LLC | Pharmacy | 1830 Greenwood Rd, Prescott, MI 48756-8627 | 2020-09-08 |
| 1023621190 | Azam Mohsen Mesleh | Pharmacy | 6811 Theisen St, Dearborn, MI 48126-1927 | 2020-08-28 |
| 1821606310 | S&k Pharmacy Inc. | Pharmacy | 1916 Davison Rd, Flint, MI 48506-4423 | 2020-07-21 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CENTRAL PHARMACY-MATTAWAN 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.