NPIMap

Organization Active NPI

PCD Corp

  • Community/Retail Pharmacy
  • Oak Park, MI
National Provider Identifier
1104059526
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301009146 Issued in MI
Legal business name
PCD CORP
Practice address
20770 Greenfield Rd
Oak Park, MI 48237-3018
Phone
(248) 548-8985
Fax
(248) 548-9935
NPI assigned
Sep 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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

Authorized official

Name
Derek Pencak
Title
President
Phone
(248) 548-9935

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301009146 MI Primary

Addresses

Primary practice location

20770 Greenfield Rd
Oak Park, MI 48237-3018

Mailing address

C/O Christopher Pencak PC
27322 23 Mile Rd, Ste 7
Chesterfield, MI 48051
Phone (586) 598-4650

Other identifiers 1

IdentifierTypeStateIssuer
2373239OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Prestige Drugs Pharmacy Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314576000000",
    "number": "1104059526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "C/O CHRISTOPHER PENCAK PC",
            "address_2": "27322 23 MILE RD, STE 7",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "48051",
            "telephone_number": "586-598-4650",
            "fax_number": "586-598-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20770 GREENFIELD RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482373018",
            "telephone_number": "248-548-8985",
            "fax_number": "248-548-9935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCD CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-02",
        "last_updated": "2011-08-29",
        "status": "A",
        "authorized_official_last_name": "PENCAK",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-548-9935"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2373239",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Drugs Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; 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.