Active NPI
Plumbrook Prescription Center Inc
- Community/Retail Pharmacy
- Sterling Heights, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- PLUMBROOK PRESCRIPTION CENTER INC
- Practice address
- 39880 Van Dyke Ave
Sterling Heights, MI 48313-4668 - Phone
- (586) 939-9580
- Fax
- (586) 978-1854
- NPI assigned
- May 22, 2006
- Last updated
- Apr 14, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Martin Newman, RPH
- Title
- President
- Phone
- (586) 939-9580
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302019905 | MI | |
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
39880 Van Dyke Ave
Sterling Heights, MI 48313-4668
Mailing address
39880 Van Dyke Ave
Sterling Heights, MI 48313-4668
Phone (586) 939-9580
Other names 1
- Plumbrook Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210510001898 | MI | Part B Supplier - Mass Immunization (Roster Biller Only) | 0244357572 | Practice locations: Sterling Heights, MI |
National Provider Directory
National Provider DirectoryLocations
39880 Van Dyke Ave
Ste 101
Sterling Heights, MI 48313
Phone (586) 939-9580
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Sterling HTS, MI
- NPI 1629290507
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1428969600000",
"number": "1104871045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39880 VAN DYKE AVE",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483134668",
"telephone_number": "586-939-9580",
"fax_number": "586-978-1854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39880 VAN DYKE AVE",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483134668",
"telephone_number": "586-939-9580",
"fax_number": "586-978-1854"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PLUMBROOK PRESCRIPTION CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-22",
"last_updated": "2015-04-14",
"status": "A",
"authorized_official_last_name": "NEWMAN",
"authorized_official_first_name": "MARTIN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "586-939-9580",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "MI",
"license": "5302019905",
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Plumbrook Pharmacy",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Sterling Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.