Henry Ford Allegiance Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010159 Issued in MI

Legal business name

HENRY FORD ALLEGIANCE PHARMACY

Practice address

205 N East Ave
Jackson, MI 49201-1753

Phone

(517) 205-4907

Fax

(517) 205-5947

NPI assigned

Oct 30, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ondrea Bates

Title

SVP-Ops/Contin of Care

Phone

(517) 205-7201

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• HENRY FORD ALLEGIANCE PHARMACY Former legal business name

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Henry Ford Health System

  • Optometrist
  • Detroit, MI
  • NPI 1346324688

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537747200000",
    "number": "1013345024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-4907",
            "fax_number": "517-205-5947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-4907",
            "fax_number": "517-205-5947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD ALLEGIANCE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-30",
        "last_updated": "2018-09-24",
        "status": "A",
        "authorized_official_last_name": "BATES",
        "authorized_official_first_name": "ONDREA",
        "authorized_official_title_or_position": "SVP-OPS/CONTIN OF CARE",
        "authorized_official_telephone_number": "517-205-7201"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142662",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "MI6500",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HENRY FORD ALLEGIANCE PHARMACY",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Cathleen Hendrick
• Renee Hendrick, ANP
• Theresa Louise Hendrick, RN
• Jessica Hendricks, LMSW
• Chandra Hendrickson
• Ivy Henry
• Rachel Henry
• Brieanne M Hensley, ATC
• Ella Hephzibah
• Erica Hepker, FNP-C

• Community/Retail Pharmacy in Jackson, MI
• Providers in Jackson, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.