Advance Care RX, LLC

Organization Active NPI Community/Retail Pharmacy · Berrien Springs, MI

NPI 1104424530 · NPPES record last updated Oct 16, 2020

Key facts

NPI
1104424530
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
ADVANCE CARE RX, LLC
Practice address
500 N Cass St
Berrien Springs, MI 49103-1069
Phone
(269) 815-5418
Fax
(269) 815-5459
NPI assigned
Oct 16, 2020
Organization subpart
No

Authorized official

Name
Okwara Nwoke, RPH
Title
Pharmacist
Phone
(269) 815-5418

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210217001840 MI Part B Supplier - Mass Immunization (Roster Biller Only) 7911312327 Practice locations: Berrien Springs, MI
O20210303003409 MI Part B Supplier - Pharmacy 7911312327 Practice locations: Berrien Springs, MI

National Provider Directory

Locations

500 N Cass St
Berrien Springs, MI 49103
Phone (269) 815-5418

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Yes

Addresses

Primary practice location

500 N Cass St
Berrien Springs, MI 49103-1069

Mailing address

500 N Cass St
Berrien Springs, MI 49103-1069
Phone (269) 815-5418

Other providers in Berrien Springs, MI

All providers in Berrien Springs, MI · Community/Retail Pharmacy in Michigan

Sources for this page

Verify at the official NPI Registry.