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
-
Okwara W Nwoke, RPH
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Berrien Springs, 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 Oct 16, 2020. 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.