SKIDWAY PHARMACY LLC (NPI# 1851905707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851905707 |
| Entity Type | Organization |
| Organization Name | SKIDWAY PHARMACY LLC |
| Practice Address |
1830 Greenwood Rd Prescott MI 48756-8627 |
| Mailing Address |
Po Box 4488 Prescott MI 48756-4488 |
| Practice Telephone | 9892961360 |
| Practice Fax Number | 9892961362 |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-08 |
| Authorized Official Name | RICHARD A SPIES JR. (OWNER) |
| Authorized Official Telephone | 9893876005 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Street Address |
1830 GREENWOOD RD |
| City | PRESCOTT |
| State | MI |
| Zip Code | 48756-8627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932571056 | Gabriel Wayne Wallace | Technician | 5208 Michiban Ave., Prescott, MI 48756 | 2015-10-28 |
| 1881622835 | Prescott Clinic P.C. | Family Medicine | 125 Washington, Prescott, MI 48756 | 2006-06-29 |
| 1568005569 | Jennifer Lynn Datzko | Nurse Practitioner | 125 N Washington St, Prescott, MI 48756-5117 | 2019-10-22 |
| 1295248508 | Prescott Clinic P.C. | Family Medicine | 125 N Washington St, Prescott, MI 48756-5117 | 2017-11-08 |
| 1407194954 | Jimmie S Ward Sr. | Physician Assistant | 125 Washington Ave, Prescott, MI 48756-5117 | 2013-01-17 |
| 1992831960 | Charles E Jessup | Family Medicine | 125 N Washington St, Prescott, MI 48756-5117 | 2007-02-26 |
| 1578626735 | Richard Steven Gaft | Emergency Medicine | 125 N Washington St, Box 114, Prescott, MI 48756-5117 | 2006-12-19 |
| 1659379915 | Antonio F Mendiola Jr. | General Practice | 1827 Greenwood Rd, Prescott, MI 48756-8626 | 2005-07-12 |
| 1881679645 | Sterling Area Health Center | Clinic/Center | 1827 Greenwood Rd, Prescott, MI 48756-8626 | 2005-12-14 |
| 1750319083 | Daniel Edward Greene | Chiropractor | 1818 Greenwood Rd, Prescott, MI 48756-8627 | 2006-06-28 |
| Find all providers in zip 48756 | ||||
| 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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| 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.