THUNDER BAY COMMUNITY HEALTH SERVICE, INC (NPI# 1528158441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528158441 |
| Entity Type | Organization |
| Organization Name | THUNDER BAY COMMUNITY HEALTH SERVICE, INC |
| Other Organization Name | THUNDER BAY PHARMACY |
| Practice Address |
11899 M 32 Atlanta MI 49709-9374 |
| Mailing Address |
Po Box 850 11899 M32 Atlanta MI 49709-0850 |
| Practice Telephone | 9897855535 |
| Practice Fax Number | 9897855267 |
| Mailing Telephone | 9897855535 |
| Mailing Fax Number | 9897855267 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2017-04-06 |
| Authorized Official Name | LORI WINEMAN (PHARMACY DIRECTOR) |
| Authorized Official Telephone | 9897855535 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301007563 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 2363959 | 01 | |
| MI | 2363959 | 05 |
| Other Name | Type Code |
|---|---|
| THUNDER BAY PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396382677 | Thunder Bay Community Health Service, Inc | Clinic/Center | 609 W Central Ave Rm Tb1, Mackinaw City, MI 49701-9650 | 2019-12-05 |
| 1609435536 | Thunder Bay Community Health Service, Inc | Clinic/Center | 1033 W Huron Ave Rm Tb1, Rogers City, MI 49779-1428 | 2019-06-13 |
| 1952960197 | Thunder Bay Community Health Service, Inc | Clinic/Center | 311 N Washington St Rm Tb1, Hale, MI 48739-8516 | 2019-06-11 |
| 1750864112 | Thunder Bay Community Health Service, Inc | Clinic/Center | 5993 W Sholes St, Wolverine, MI 49799-9549 | 2018-09-12 |
| 1396292777 | Thunder Bay Community Health Service, Inc | Clinic/Center | 13131 Brook St, Wolverine, MI 49799-8406 | 2016-09-02 |
| 1750751392 | Thunder Bay Community Health Service, Inc | Clinic/Center | 1110 8th Street, Mio, MI 48647-9140 | 2015-09-25 |
| 1558730234 | Thunder Bay Community Health Service, Inc | Clinic/Center | 1879 E Miller Rd, Fairview, MI 48621-8705 | 2015-09-23 |
| 1467837336 | Thunder Bay Community Health Service, Inc | Clinic/Center | 4363 S Straits Hwy, Indian River, MI 49749-9457 | 2015-07-21 |
| 1568846574 | Thunder Bay Community Health Service, Inc | Clinic/Center | 6800 Wilson Rd, Indian River, MI 49749-9447 | 2015-07-20 |
| 1124402136 | Thunder Bay Community Health Service, Inc | Clinic/Center | 4580 Montmorency St, Lewiston, MI 49756-7862 | 2015-07-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | THUNDER BAY COMMUNITY HEALTH SERVICE, INCORPORATED | 15774 State St, Hillman, MI 49746-8818 |
| Street Address |
11899 M 32 |
| City | ATLANTA |
| State | MI |
| Zip Code | 49709-9374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437101680 | Wayne K Mcewen | Physician Assistant | 11899 M 32, Atlanta, MI 49709-9374 | 2006-05-16 |
| 1497316210 | Emily F Hill | Dentist | 11899 M 32, Atlanta, MI 49709-9374 | 2019-06-24 |
| 1528627247 | Patrick Dionise | Dentist | 11899 M 32, Atlanta, MI 49709-9374 | 2019-06-06 |
| 1275094617 | Nickole L Stein-fisher | Social Worker | 11899 M 32, Atlanta, MI 49709-9374 | 2019-03-28 |
| 1245703198 | Brenna E Hincka | Dental Hygienist | 11899 M 32, Atlanta, MI 49709-9374 | 2019-01-03 |
| 1164991527 | Lori M Wineman | Pharmacist | 11899 M 32, Atlanta, MI 49709-9374 | 2018-11-15 |
| 1104336163 | Emily F Hoffmeyer | Dental Assistant | 11899 M 32, Atlanta, MI 49709-9374 | 2017-10-04 |
| 1003335449 | Lynn M Radka | Dental Hygienist | 11899 M 32, Atlanta, MI 49709-9374 | 2017-09-18 |
| 1689192809 | Amy J Code | Nurse Practitioner | 11899 M 32, Atlanta, MI 49709-9374 | 2017-09-08 |
| 1225390008 | Shannon L. Avenall | Social Worker | 11899 M 32, Atlanta, MI 49709-9374 | 2012-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881960722 | Thunder Bay Community Health Service, Inc | Clinic/Center | 10500 County Road 489, Atlanta, MI 49709 | 2012-03-26 |
| 1043441975 | Midmichigan Medical Center-alpena | Durable Medical Equipment & Medical Supplies | 12674 Jerome St., Atlanta, MI 49709 | 2009-07-27 |
| 1063598241 | Henry Franklin Herlick | Dentist | 12551 Jerome St, Atlanta, MI 49709 | 2006-10-31 |
| 1437362902 | Ronald J. Looney | Chiropractor | 12418 State St., Atlanta, MI 49709-0855 | 2007-05-08 |
| 1427055680 | Tanya Joyce Rock | Social Worker | 5375 E Sandy Trl, Atlanta, MI 49709-8956 | 2005-07-02 |
| 1912444605 | Rachael Sherbonda | Behavior Technician | 8051 County Road 489, Atlanta, MI 49709-9031 | 2017-01-19 |
| 1174999098 | Montmorency County Commission On Aging | Home Health | 11463 Mcarthur Rd, Atlanta, MI 49709-9192 | 2015-08-14 |
| 1316998909 | Tri - Township Ambulance Service | Ambulance | 11413 Parland St, Atlanta, MI 49709-9271 | 2006-05-16 |
| 1831179597 | Professional Breathing Associates Inc | Durable Medical Equipment & Medical Supplies | 12519 State St, Atlanta, MI 49709-9622 | 2006-01-19 |
| 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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| 1912357641 | Headland Pharmacy LLC | Pharmacy | 2973 Headland Drive, Suite B, Atlanta, GA 30331 | 2016-06-14 |
| 1285022277 | Express Food & Pharmacy Investment LLC | Pharmacy | 2111 Campbellton Rd Sw, Atlanta, GA 30311-4605 | 2014-12-30 |
| 1881024479 | Camp Creek Village Pharmacy Inc. | Pharmacy | 3220 Butner Rd Sw Suite #130, Atlanta, GA 30331 | 2013-11-18 |
| 1487093662 | Pharm Holdings | Pharmacy | 102 E Allday St, Atlanta, TX 75551-2305 | 2013-06-20 |
| 1255676326 | Eastlake Pharmacy Inc | Pharmacy | 1308 Glenwood Ave Se, Atlanta, GA 30316-2077 | 2012-11-30 |
| 1689918468 | Wal-mart Stores East Lp | Pharmacy | 835 Martin Luther King Jr Dr Nw, Atlanta, GA 30314-3644 | 2012-11-19 |
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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.