SCOTT POLIVKA (NPI# 1477190270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477190270 |
| Entity Type | Individual |
| Full Name | SCOTT POLIVKA |
| Practice Address |
921 W Holmes Rd Lansing MI 48910-0439 |
| Mailing Address |
900 Long Blvd Apt 214 Lansing MI 48911-6705 |
| Practice Telephone | 5173937009 |
| Mailing Telephone | 5172752871 |
| Enumeration Date | 2019-11-30 |
| Last Update Date | 2019-11-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
5302036186 | MI | Pharmacy Service Providers |
| Street Address |
921 W HOLMES RD |
| City | LANSING |
| State | MI |
| Zip Code | 48910-0439 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033143870 | Kroger Co of Michigan | Durable Medical Equipment & Medical Supplies | 921 W Holmes Rd, Lansing, MI 48910-0439 | 2006-07-10 |
| 1245877026 | Garett Jon Findlay | Pharmacist | 921 W Holmes Rd, Lansing, MI 48910-0439 | 2019-11-29 |
| 1073159141 | Haleigh Marsh | Pharmacist | 921 W Holmes Rd, Lansing, MI 48910-0439 | 2019-11-22 |
| 1629167184 | Marcelo M Couto | Pharmacist | 921 W Holmes Rd, Pharmacy Dept., Lansing, MI 48910-0439 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821604562 | Wendy Lynne Hughes | Licensed Practical Nurse | 2025 S Washington Ave Suite 210 Lansing, Mi 48910, Lansing, MI 48910 | 2020-09-18 |
| 1073146908 | James Laroach | Peer Specialist | 913 W. Homes Suite 200, Lansing, MI 48910 | 2020-02-19 |
| 1487284279 | Kourtia Nicole Munson | Counselor | 2025 S Washighton Ave, Suite 210, Lansing, MI 48910 | 2020-01-21 |
| 1699248112 | Cedar Pharmacy LLC | Pharmacy | 2513 S Cedar St., Lansing, MI 48910 | 2019-01-08 |
| 1134604390 | Kazuho Kondo | Student in an Organized Health Care Education/Training Program | 3338 Beau Jardin Dr., 0812, Lansing, MI 48910 | 2018-10-03 |
| 1477036655 | Dalia Elgohary | Pharmacist | 5016 S Martin Luther King, Lansing, MI 48910 | 2018-09-13 |
| 1457856940 | Derrick Lynn Byrd | Social Worker | 4305 S. Cedar St., Lansing, MI 48910 | 2018-03-27 |
| 1326564964 | Lansing Health Supplies | Durable Medical Equipment & Medical Supplies | 3105 S Martin Luther King Blvd #320, Lansing, MI 48910 | 2017-08-15 |
| 1265957203 | Heather E Dover | Dietitian, Registered | 2510 Solomon Dr, Lansing, MI 48910 | 2017-08-10 |
| 1407307705 | Elise Evans | Occupational Therapist | 2331 East Jolly Rd, Suite B, Lansing, MI 48910 | 2016-10-21 |
| Find all providers in zip 48910 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447713946 | Fadi Nuseibeh | Pharmacist | 3955 Patient Care Drive, Pharmacy, Lansing, MI 48911 | 2019-04-11 |
| 1477036655 | Dalia Elgohary | Pharmacist | 5016 S Martin Luther King, Lansing, MI 48910 | 2018-09-13 |
| 1841836236 | Charles Main | Pharmacist | 6430 W Saginaw Hwy, Lansing, MI 48917-1106 | 2019-11-21 |
| 1427445915 | Denise M.2 Pratt | Pharmacist | 1210 E Michigan Ave, Pharmacy Department, Lansing, MI 48912-1812 | 2015-04-22 |
| 1912250374 | Sarah Elysse Hill | Pharmacist | 812 E Jolly Rd, Suite 208, Lansing, MI 48910-6818 | 2012-10-23 |
| 1275789760 | Anne Renae Ottney | Pharmacist | 1200 E Michigan Ave, Suite 245a, Lansing, MI 48912-1800 | 2008-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578163069 | Alaric Michael Nielson | Pharmacist | 158 Schoolcraft St, Lake Linden, MI 49945-1328 | 2020-10-26 |
| 1598380529 | Daniel Asare Offei | Pharmacist | 2539 Sagewood Ave Ne Unit 718, Grand Rapids, MI 49525-2952 | 2020-06-16 |
| 1013540426 | Aiman Abueida | Pharmacist | 17000 Executive Plaza Dr Ste 201, Dearborn, MI 48126-2793 | 2020-02-14 |
| 1336770866 | Azadeh Ali Moghaddam | Pharmacist | 5951 Sunrise Dr, Ypsilanti, MI 48197-7498 | 2020-02-03 |
| 1811527104 | Bailey Elaine Johnson | Pharmacist | 626 W Front St, Traverse City, MI 49684-2210 | 2020-01-25 |
| 1588202089 | Kenneth Alexander | Pharmacist | 40339 Grand River Ave # 110, Novi, MI 48375 | 2019-12-15 |
| 1760020333 | Deborah Handrinos Njus | Pharmacist | 19028 Stonewater Blvd, Northville, MI 48168-8560 | 2019-12-14 |
| 1255978037 | Dana Trudell | Pharmacist | 829 W 4th St, Pinconning, MI 48650-8907 | 2019-11-29 |
| 1174169270 | Debra Joyce Lammers | Pharmacist | 531 West Main Street, Milan, MI 48160 | 2019-11-23 |
| 1467098533 | Thomas Aaron | Pharmacist | 4194 Glenbrook Ct, Sterling Heights, MI 48310-3378 | 2019-11-22 |
| 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.