Pca-Corrections LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

5301009951 Issued in MI

Legal business name

PCA-CORRECTIONS LLC

Practice address

4665 44TH St SE Ste A1106
Grand Rapids, MI 49512-4052

Phone

(616) 977-9700

Fax

(616) 855-0937

NPI assigned

May 26, 2009

Organization subpart

No

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

Authorized official

Name

Cristina Pietrowski

Title

Evp, Chief Legal Officer & Secretar

Phone

(502) 412-5847

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Synchrony Grand Rapids Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Pca-Corrections LLC

  • Long Term Care Pharmacy
  • Louisville, KY
  • NPI 1548231293

  8527085497

  Same PAC ID
• Pca-Corrections LLC

  • Long Term Care Pharmacy
  • Indianapolis, IN
  • NPI 1639608458

  8527085497

  Same PAC ID
• Pca-Corrections LLC

  • Long Term Care Pharmacy
  • Hilliard, OH
  • NPI 1750392312

  8527085497

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Practitioners 2

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

• Dana Harshbarger, PHARMD

  • Pharmacist
  • Grand Rapids, MI
  • NPI 1679179303
  NPD (past)
• Colten Redder, PHARMD

  • Pharmacist
  • Grand Rapids, MI
  • NPI 1376139824
  NPD (past)

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753833600000",
    "number": "1083849640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N HURSTBOURNE PKWY STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225158",
            "telephone_number": "800-445-8917",
            "fax_number": "800-445-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4665 44TH ST SE STE A1106",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495124052",
            "telephone_number": "616-977-9700",
            "fax_number": "616-855-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCA-CORRECTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-26",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A",
        "authorized_official_last_name": "PIETROWSKI",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_title_or_position": "EVP, CHIEF LEGAL OFFICER & SECRETAR",
        "authorized_official_telephone_number": "502-412-5847"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MI",
            "license": "5301009951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2137979",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synchrony Grand Rapids Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Conrad Payne
• Kionna Lashaun Payne, LPN
• Natalie Anna Payne, MD
• Robert Craig Payne, D.D.S.
• Thea Pazdernik
• Peace Love Counseling, LLC
• Peaceful Group Home LLC
• Peaceful Homecare LLC
• Cynthia Elizabeth Louise Peacock, MD
• Daniel Peacock, MSW

• Long Term Care Pharmacy in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Long Term Care Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.