WOODWARD DETROIT CVS LLC (NPI# 1619125069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619125069 |
| Entity Type | Organization |
| Organization Name | WOODWARD DETROIT CVS LLC |
| Other Organization Name | CVS PHARMACY #17198 |
| Practice Address |
20877 Hall Rd Macomb MI 48044-4256 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 5864641129 |
| Practice Fax Number | 5864641139 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2016-09-28 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301010863 | MI | Suppliers |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2116726 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #17198 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093181943 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 2506 Niles Ave, Saint Joseph, MI 49085-1924 | 2015-08-14 |
| 1902292881 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 1015 S Saginaw Rd, Midland, MI 48640-5642 | 2015-04-08 |
| 1386992204 | Woodward Detroit Cvs LLC | Pharmacy | 626 West Front St, Traverse City, MI 49684-2210 | 2012-08-27 |
| 1073748000 | Woodward Detroit Cvs LLC | Pharmacy | 28800 Dequindre Rd, Warren, MI 48092-2466 | 2009-05-20 |
| 1528216975 | Woodward Detroit Cvs LLC | Pharmacy | 2400 S Telegraph Rd, Bloomfield Hills, MI 48302-0255 | 2008-08-28 |
| 1508042524 | Woodward Detroit Cvs LLC | Pharmacy | 47330 Michigan Ave, Canton, MI 48188-2582 | 2008-01-22 |
| 1417141482 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 5057 Harvey St, Norton Shores, MI 49444-9795 | 2007-08-31 |
| 1760532089 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 5350 W Main St, Kalamazoo, MI 49009-3304 | 2007-01-11 |
| 1619027950 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 2310 Metropolitan Pkwy, Sterling Heights, MI 48310-4209 | 2007-01-11 |
| 1336221704 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 35401 Warren Rd, Westland, MI 48185-6590 | 2006-10-19 |
| Street Address |
20877 HALL RD |
| City | MACOMB |
| State | MI |
| Zip Code | 48044-4256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407463102 | Alyssa Hansen | Pharmacy | 20877 Hall Rd, Macomb, MI 48044-4256 | 2020-09-26 |
| 1003446386 | Meghan Rock | Pharmacist | 20877 Hall Rd, Macomb, MI 48044-4256 | 2020-01-25 |
| 1124382759 | Rachelle Marie Christensen | Pharmacist | 20877 Hall Rd, Macomb, MI 48044-4256 | 2012-06-28 |
| 1215221122 | Linda Mamou | Pharmacist | 20877 Hall Rd, Macomb, MI 48044-4256 | 2011-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265925788 | Karen Wetzel | Social Worker | 47567 Dennis Baert Dr, Macomb, MI 48044 | 2018-06-09 |
| 1225541956 | Paul John Andary Jr. | Student in an Organized Health Care Education/Training Program | 48599 Penrose Ln, Macomb, MI 48044 | 2017-11-16 |
| 1467972869 | Theresa Lynn Cipponeri | Social Worker | 17937 Hall Road, Macomb, MI 48044 | 2017-06-27 |
| 1407389570 | Nofal Cholag | Pharmacist | 50340 Nesting Ridge Dr, Macomb, MI 48044 | 2017-04-06 |
| 1043754914 | Magdalena Sosnowski | Registered Nurse | 47362 Whippoorwill Dr, Macomb, MI 48044 | 2016-12-13 |
| 1558716894 | Keith Edward Callewaert | Emergency Medical Technician, Paramedic | 48301 Tonawonda Dr, Macomb, MI 48044 | 2016-04-24 |
| 1942684741 | Isabella Scofield | Family Medicine | 46591 Romeo Plank Rd Ste 200, Macomb, MI 48044 | 2015-07-13 |
| 1548600984 | Katie Marie Rosen | Urology | 19991 Hall Rd Ste 201, Macomb, MI 48044 | 2013-06-30 |
| 1699118455 | Kostyantyn Shkilnyy | Massage Therapist | 48254 Ellington Drive, Macomb Township, MI 48044 | 2013-04-11 |
| 1962790097 | Daniel Agrusa | Audiologist | 49306 Flint Ct., Macomb, MI 48044 | 2011-07-11 |
| Find all providers in zip 48044 | ||||
| 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 |
|---|---|---|---|---|
| 1639287097 | Bloch Drugs Co Inc | Pharmacy | 16828 21 Mile Rd, Macomb, MI 48044-2601 | 2006-08-27 |
| 1982252953 | Margaret Matthews | Pharmacy | 46977 Romeo Plank Rd, Macomb, MI 48044-3509 | 2019-09-03 |
| 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 | ||||
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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.