PINE KNOB PHARMACY #3, INC. (NPI# 1891803268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891803268 |
| Entity Type | Organization |
| Organization Name | PINE KNOB PHARMACY #3, INC. |
| Other Organization Name | SAV-MOR #38 PINE KNOB #3 |
| Practice Address |
6770 Dixie Highway Suite 201 Clarkston MI 48346 |
| Practice Telephone | 2486203588 |
| Practice Fax Number | 2486200037 |
| Mailing Telephone | 2486203588 |
| Mailing Fax Number | 2486200037 |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2016-10-27 |
| Authorized Official Name | MR. RAY ALEXANDER BULLARD (PRESIDENT) |
| Authorized Official Telephone | 2486203588 |
| Authorized Official Credential | R.PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301006232 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER | 2354126 | 01 | |
| NABP/NCPDP | 2354126 | 01 |
| Other Name | Type Code |
|---|---|
| Sav-Mor #38 Pine Knob #3 | Doing Business As Name - Organization |
| Street Address |
6770 DIXIE HIGHWAY SUITE 201 |
| City | CLARKSTON |
| State | MI |
| Zip Code | 48346 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588742878 | Ala Eddin Imam | Internal Medicine | 6770 Dixie Highway, Suite 301, Clarkston, MI 48346 | 2006-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497399745 | Therapy Services of Clarkston LLC | Clinic/Center | 6770 Dixie Highway, Suite 103, Clarkston, MI 48346 | 2019-10-30 |
| 1679041545 | Shiba Lashon Nixon | Registered Nurse | New Oakland, 6549 Town Center Suite A, Clarkston, MI 48346 | 2018-11-08 |
| 1972079655 | Stephanie Gaumer | Social Worker | 6825 Dixie Hwy Ste E, Clarkston, MI 48346 | 2018-10-19 |
| 1912496324 | Regency At Independence Township, LLC | Skilled Nursing Facility | 6211 Stonewood Drive, Clarkston, MI 48346 | 2018-05-02 |
| 1558880591 | 3rd Circle Inc. | Home Health Aide | 39 South Main Street, Ste 2, Clarkston, MI 48346 | 2017-09-11 |
| 1376083246 | Rosemarie Villarreal | Social Worker | 4480 Elmdale Ave, Clarkston, MI 48346 | 2017-02-27 |
| 1932566940 | Syncere Hearts Home Healthcare, LLC | Home Health | 5836 North Marshbank Lane Apt203, Clarkston, MI 48346 | 2016-01-21 |
| 1649635087 | Coddaire & Associates, Inc. | Community/Behavioral Health | 6445 Citation Drive, Suite H, Clarkston, MI 48346 | 2015-12-30 |
| 1013386358 | Victoria Urikh-garcia | Technician, Other | 6510 Town Center Dr Ste E, Clarkston, MI 48346 | 2015-09-16 |
| 1194090993 | Stefanie Pavloski | Counselor | 5701 Bow Pointe Dr., Ste. #380, Clarkston, MI 48346 | 2012-03-13 |
| Find all providers in zip 48346 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225375603 | Zak Pharmacy LLC. | Pharmacy | 4600 E Ponce De Leon Ave Ste E, Clarkston, GA 30021-1839 | 2013-01-06 |
| 1598040271 | Walgreen Co | Pharmacy | 7110 Dixie Hwy., Clarkston, MI 48371 | 2011-10-13 |
| 1144429952 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 5756 Clarkston Rd, Clarkston, MI 48348-4706 | 2007-07-12 |
| 1245300797 | Clarkston Heights Pharmacy | Pharmacy | 2119 5th Ave, Clarkston, WA 99403-1406 | 2006-11-09 |
| 1174625453 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 5529 Sashabaw Rd, Clarkston, MI 48346-3147 | 2006-09-05 |
| 1346352283 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 7091 Dixie Hwy, Clarkston, MI 48346-2076 | 2006-08-31 |
| 1255449625 | Pine Knob Pharmacy 4 Inc | Pharmacy | 5710 Bella Rosa Blvd, Clarkston, MI 48348-4773 | 2006-08-27 |
| 1811902943 | Walgreen Co | Pharmacy | 7110 Dixie Hwy, Clarkston, MI 48346-2014 | 2006-07-29 |
| 1679509251 | U.n. Pharmcay | Pharmacy | 3652 Market St, Unit C-1, Clarkston, GA 30021-1298 | 2006-06-24 |
| 1679569362 | Clarkstonrx LLC | Pharmacy | 5838 S Main St, Clarkston, MI 48346-2963 | 2005-09-27 |
| Find all providers in CLARKSTON | ||||
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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.