WOODWARD DETROIT CVS, L.L.C. (NPI# 1609975903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609975903 |
| Entity Type | Organization |
| Organization Name | WOODWARD DETROIT CVS, L.L.C. |
| Other Organization Name | CVS PHARMACY #08304 |
| Practice Address |
61019 Silver Lake Rd South Lyon MI 48178-9209 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 2484378626 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2011-02-23 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR) |
| Authorized Official Telephone | 4017651500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | 5301008020 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2366347 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #08304 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861796112 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 3590 Plainfield Ave Ne, Grand Rapids, MI 49525-2719 | 2010-12-30 |
| 1790002921 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 5449 Jackson Rd, Ann Arbor, MI 48103 | 2010-04-28 |
| 1033374319 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 7488 Village Center Dr., Whitmore Lake, MI 48189 | 2008-07-25 |
| 1922273424 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 57090 Ten Mile Rd, South Lyon, MI 48178-9718 | 2008-04-25 |
| 1922271162 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 15521 West Seven Mile Road, Detroit, MI 48235 | 2008-04-09 |
| 1326216797 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 44300 Five Mile Rd., Northville Township, MI 48167 | 2008-02-19 |
| 1538352976 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 51000 Romeo Plank Rd, Macomb, MI 48042-4128 | 2007-08-20 |
| 1144429952 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 5756 Clarkston Rd, Clarkston, MI 48348-4706 | 2007-07-12 |
| 1811195993 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 50980 North Ave, Macomb, MI 48042-4626 | 2007-07-10 |
| 1356481352 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 5408 Whittaker Road, Ypsilanti Township, MI 48197 | 2007-02-07 |
| Street Address |
61019 SILVER LAKE RD |
| City | SOUTH LYON |
| State | MI |
| Zip Code | 48178-9209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235761560 | Anitha Dasari | Pharmacist | 61019 Silver Lake Rd, South Lyon, MI 48178-9209 | 2020-02-05 |
| 1750912374 | Ladonna Slattery | Pharmacist | 61019 Silver Lake Rd, South Lyon, MI 48178-9209 | 2020-02-02 |
| 1891326039 | Salima Sami Matariyeh | Pharmacist | 61019 Silver Lake Rd, South Lyon, MI 48178-9209 | 2020-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083231815 | Bhoomi Shah | Pharmacist | 22318 Pontiac Trail, South Lyon, MI 48178 | 2020-06-27 |
| 1649811845 | Center for Emdr and Trauma Therapy | Counselor | 28900 Pontiac Trail, South Lyon, MI 48178 | 2019-09-30 |
| 1295223386 | Cathrine Michelle Arneson | Massage Therapist | 321 Pettibone St. #101a, South Lyon, MI 48178 | 2018-04-25 |
| 1033592936 | 4-serv Family Medicine P.C. | Family Medicine | 51619 Ten Mile Rd, South Lyon, MI 48178 | 2015-07-09 |
| 1003299777 | James Sullivan | Physical Therapy Assistant | 10821 Bouldercrest Drive, South Lyon, MI 48178 | 2015-06-30 |
| 1255722088 | Jennifer Nidetz | Social Worker | 23015 Cheyenne Dr, South Lyon, MI 48178 | 2015-02-16 |
| 1174938658 | Michael Samir Matar | Family Medicine | 210 N Lafayette Street, South Lyon, MI 48178 | 2014-06-24 |
| 1043633191 | Kwonsoo Kenneth Kim | Anesthesiology | 8854 Stoney Creek Dr., South Lyon, MI 48178 | 2014-01-27 |
| 1285071860 | Ajanthan Sivagurunathan | Student in an Organized Health Care Education/Training Program | 210 North Lafayette, Providence Medical Center - South Lyon, South Lyon, MI 48178 | 2013-05-23 |
| 1184890055 | Yvonne Marie Snyder | Dentist | 100 E Lake St, South Lyon, MI 48178 | 2008-05-01 |
| Find all providers in zip 48178 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184649741 | Bormans Inc | Pharmacy | 22385 Pontiac Trl, South Lyon, MI 48178-1646 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961763 | Dustyn Daniel Thoney | Pharmacy | 530 Harding Ave, Iron River, MI 49935-2265 | 2020-10-27 |
| 1497355697 | Katherine Jane Cybulski | Pharmacy | 1310 Waukazoo St, Hastings, MI 49058-9559 | 2020-10-27 |
| 1043836042 | Hanan Pharmacy LLC | Pharmacy | 4600 E 14 Mile Road, Suite 2, Warren, MI 48092-1057 | 2020-06-25 |
| 1770104192 | Hazelwood Pharmacy LLC | Pharmacy | 624 E 9 Mile Rd Ste C, Hazel Park, MI 48030-1842 | 2020-04-27 |
| 1457980609 | Berkley Pharmacy LLC | Pharmacy | 28577 Schoenherr Road, Warren, MI 48088 | 2020-04-08 |
| 1669012316 | Warriors Pharmacy, Inc. | Pharmacy | 5265 Anthony Wayne Dr, Detroit, MI 48202-3947 | 2020-01-10 |
| 1457996662 | Sunrise Pharmacy, LLC | Pharmacy | 989 University Dr Ste 104, Pontiac, MI 48342-1885 | 2019-11-12 |
| 1447894019 | Nova Pharmacy | Pharmacy | 15140 Levan Rd, Suite 40, Livonia, MI 48154 | 2019-11-06 |
| 1912541673 | Wayne Pharma | Pharmacy | 974 Ford Ave, Wyandotte, MI 48192 | 2019-11-05 |
| 1639720667 | Grand Haven Pharmacy LLC | Pharmacy | 930 John R Rd Ste Pharmacy, Troy, MI 48083-4316 | 2019-09-20 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH LYON |
| Zip Code | 48178 |
Please comment or provide details below to improve the information on WOODWARD DETROIT CVS, L.L.C..
| 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.