Active NPI
Michael Pavlik, PHARMD
- Pharmacist
- East Lansing, MI
National Provider Identifier
1013427715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302041965
- Practice address
- 2489 E Lake Lansing Rd
East Lansing, MI 48823-9712 - Phone
- (517) 332-0888
- NPI assigned
- Oct 7, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302041965 | MI | Primary |
Addresses
Primary practice location
2489 E Lake Lansing Rd
East Lansing, MI 48823-9712
Mailing address
2489 E Lake Lansing Rd
East Lansing, MI 48823-9712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302041965 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rite Aid of Michigan Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Rite Aid Pharmacy 04068
- Community/Retail Pharmacy
- Washington, MI
- NPI 1619117405
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507334400000",
"number": "1013427715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2489 E LAKE LANSING RD",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488239712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2489 E LAKE LANSING RD",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488239712",
"telephone_number": "517-332-0888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVLIK",
"first_name": "MICHAEL",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-10-07",
"last_updated": "2017-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302041965",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.