THE COUNTRY SQUIRE DISCOUNT PHARMACY, INC (NPI# 1700887148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700887148 |
| Entity Type | Organization |
| Organization Name | THE COUNTRY SQUIRE DISCOUNT PHARMACY, INC |
| Other Organization Name | COUNTRY SQUIRE PHARMACY |
| Practice Address |
30 E Main Fremont MI 49412-1244 |
| Practice Telephone | 2319242120 |
| Practice Fax Number | 2319246310 |
| Mailing Telephone | 2319242120 |
| Mailing Fax Number | 2319246310 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2008-07-16 |
| Authorized Official Name | MR. JUDSON K AFMAN (PRESIDENT) |
| Authorized Official Telephone | 2319242120 |
| Authorized Official Credential | R. PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 5301001172 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 87411545 | 05 | |
| MI | BCBS OF MI DME | 540F210020 | 01 |
| Other Name | Type Code |
|---|---|
| Country Squire Pharmacy | Doing Business As Name - Organization |
| Street Address |
30 E MAIN |
| City | FREMONT |
| State | MI |
| Zip Code | 49412-1244 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437632437 | Claire Marie J Derks | Massage Therapist | 119 North Stone Road, Fremont, MI 49412 | 2018-09-14 |
| 1730565946 | Retirement Living Management of Fremont, L.L.C. | Assisted Living Facility | 801 E. Main Street, Fremont, MI 49412 | 2015-08-11 |
| 1497136410 | James Yon | Social Worker | 3682 S Maple Island Rd, Fremont, MI 49412 | 2015-06-16 |
| 1871864090 | Cheryl Lee Kublin | Specialist | 4554 W. 48th St, Fremont, MI 49412 | 2012-01-19 |
| 1326319583 | Colleen M Rice | Occupational Therapist | 4554 W. 48th Street, Fremont, MI 49412 | 2012-01-19 |
| 1154578847 | Greenlund Enterprises, Inc | Hearing Aid Equipment | 28 Wet Sheridan Street, Fremont, MI 49412 | 2008-08-25 |
| 1225170699 | Raymond Prins IIi | Dentist | 855 N Darling, Fremont, MI 49412 | 2007-02-13 |
| 1508933789 | Charles Merle Erickson | Dentist | 16 W Sheridan, Fremont, MI 49412 | 2006-11-30 |
| 1588741300 | Christopher Callis Niquette | Dentist | 327 Apache Dr, Fremont, MI 49412 | 2006-11-01 |
| 1417041179 | Newaygo County Resa | Local Education Agency (LEA) | 4747 W. 48th Street, Fremont, MI 49412 | 2006-10-03 |
| Find all providers in zip 49412 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342036 | Aria Healthcare Inc | Durable Medical Equipment & Medical Supplies | 37179 Fremont Blvd, Fremont, CA 94536 | 2020-10-06 |
| 1922626423 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2740 N Clarkson St Ste P1, Fremont, NE 68025-7703 | 2020-07-10 |
| 1376007518 | Meijer, Inc. | Durable Medical Equipment & Medical Supplies | 4665 S Green Ave, Fremont, MI 49412-9509 | 2019-01-22 |
| 1184191470 | Air for Life LLC. | Durable Medical Equipment & Medical Supplies | 2140 Peralta Blvd Ste 200, Fremont, CA 94536-3960 | 2018-10-25 |
| 1114354271 | Synergy Medical Solutions Inc | Durable Medical Equipment & Medical Supplies | 37317 Fremont Blvd, Fremont, CA 94536-3702 | 2013-10-03 |
| 1972847721 | Svc Corporation | Durable Medical Equipment & Medical Supplies | 48834 Kato Rd, Suite 101-a, Fremont, CA 94538-7371 | 2012-11-17 |
| 1407126055 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 43950 Pacific Commons Blvd, Fremont, CA 94538-3803 | 2012-01-12 |
| 1043591787 | Francis Joseph Lim Samson | Durable Medical Equipment & Medical Supplies | 4432 Enterprise St, Ste I, Fremont, CA 94538-6331 | 2011-09-08 |
| 1013173186 | Thomas J. Overberg, O.d., Inc. | Durable Medical Equipment & Medical Supplies | 1114 E State St, Fremont, OH 43420-4358 | 2008-07-29 |
| 1982895587 | Newaygo County Community Services | Durable Medical Equipment & Medical Supplies | 6308 S Warner Ave, Fremont, MI 49412-9279 | 2007-08-08 |
| Find all providers in FREMONT | ||||
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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.