Organization Active NPI

Food Value & Pharmacy Corp

  • Community/Retail Pharmacy
  • Auburn, MI
National Provider Identifier
1033425129
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301009408 Issued in MI
Legal business name
FOOD VALUE & PHARMACY CORP
Practice address
957 W Midland Rd
Auburn, MI 48611-9406
Phone
(989) 662-7773
Fax
(989) 662-7778
NPI assigned
Aug 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Authorized official

Name
Mr. Chandresh Amin
Title
President
Phone
(989) 755-7890

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301009408 MI Primary

Addresses

Primary practice location

957 W Midland Rd
Auburn, MI 48611-9406

Mailing address

957 W Midland Rd
Auburn, MI 48611-9406
Phone (989) 662-7773

Other names 1

  • wackerly pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211229000671 MI Part B Supplier - Mass Immunization (Roster Biller Only) 8921208547 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saginaw, MI; Auburn, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Food Value Pharmacy Corp5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

310 E Midland Rd
Auburn, MI 48611
Phone (989) 662-4005

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1033425129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "957 W MIDLAND RD",
            "city": "AUBURN",
            "state": "MI",
            "postal_code": "486119406",
            "telephone_number": "989-662-7773",
            "fax_number": "989-662-7778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "957 W MIDLAND RD",
            "city": "AUBURN",
            "state": "MI",
            "postal_code": "486119406",
            "telephone_number": "989-662-7773",
            "fax_number": "989-662-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOD VALUE & PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-26",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "AMIN",
        "authorized_official_first_name": "CHANDRESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-755-7890",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "wackerly pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "wackerly pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Auburn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.