Clio Community Pharmacy Inc
Organization Active NPI Community/Retail Pharmacy · Clio, MI
NPI 1093291387 · NPPES record last updated Sep 11, 2018
Key facts
- NPI
- 1093291387
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- CLIO COMMUNITY PHARMACY INC
- Practice address
- 4180 W Vienna Rd Ste 4
Clio, MI 48420-9497 - Phone
- (810) 309-3098
- Fax
- (810) 963-2625
- NPI assigned
- Jul 19, 2018
- Organization subpart
- No
Authorized official
- Name
- Kaushal Patel
- Title
- Director
- Phone
- (810) 498-9098
Practitioners 1
-
Ronald Todd Foskett, RPH
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181025002885 | MI | Part B Supplier - Mass Immunization (Roster Biller Only) | 0042563728 | Practice locations: Clio, MI |
| O20190529002009 | MI | DME Supplier - Pharmacy | 0042563728 | Practice locations: Clio, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 5301011428 | MI | |
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
4180 W Vienna Rd Ste 4
Clio, MI 48420-9497
Mailing address
4180 W Vienna Rd Ste 4
Clio, MI 48420-9497
Phone (810) 309-3098
Other names
- Clio Community Pharmacy
Other providers in Clio, MI
- Caben Counseling, LLC
- Cameron a F C
- Canvas ABA PLLC
- Jean Chalker
- Chloe Clarambeau
- Clio Community Pharmacy Inc
- Clio Dental Center
- Clio Family Dentistry PLC
- Clio Imaging
- Clio Urgent Care PLLC
All providers in Clio, MI · Community/Retail Pharmacy in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.