NPIMap

Organization Active NPI

Lakeland Medical Center Niles

  • Institutional Pharmacy
  • Niles, MI
National Provider Identifier
1053474734
Registry record updated Apr 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
5301000048 Issued in MI
Legal business name
LAKELAND MEDICAL CENTER NILES
Practice address
31 N Saint Joseph Ave
Niles, MI 49120-2207
Phone
(269) 687-1428
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2018

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

Authorized official

Name
Tim J Calhoun
Title
VP Finance/Cfo
Phone
(269) 983-8300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X 5301000048 MI Primary

Addresses

Primary practice location

31 N Saint Joseph Ave
Niles, MI 49120-2207

Mailing address

31 N Saint Joseph Ave
Niles, MI 49120-2207
Phone (269) 687-1428

Other identifiers 1

IdentifierTypeStateIssuer
2324135OtherNCPDP

National Provider Directory

National Provider Directory
Tax ID family
Mercy Memorial Medical13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522972800000",
    "number": "1053474734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 N SAINT JOSEPH AVE",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202207",
            "telephone_number": "269-687-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 N SAINT JOSEPH AVE",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491202207",
            "telephone_number": "269-687-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND MEDICAL CENTER NILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2018-04-06",
        "status": "A",
        "authorized_official_last_name": "CALHOUN",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP FINANCE/CFO",
        "authorized_official_telephone_number": "269-983-8300"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "MI",
            "license": "5301000048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2324135",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.