NPIMap

Organization Active NPI

Hackley Community Care Center, Inc

Doing business as Community Care Pharmacy

  • Community/Retail Pharmacy
  • Muskegon, MI
National Provider Identifier
1114107547
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301008736 Issued in MI
Legal business name
HACKLEY COMMUNITY CARE CENTER, INC
Doing business as
Community Care Pharmacy
Practice address
2700 Baker St
Muskegon, MI 49444-2157
Phone
(231) 737-9510
Fax
(231) 739-0837
NPI assigned
Nov 14, 2007
Last updated
Oct 20, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
HACKLEY COMMUNITY CARE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Authorized official

Name
Mrs. Valerie Blondin
Title
Chief Finance Office
Phone
(231) 733-6657

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301008736 MI Primary

Addresses

Primary practice location

2700 Baker St
Muskegon, MI 49444-2157

Mailing address

2700 Baker St
Muskegon, MI 49444-2157
Phone (231) 737-9510

Other identifiers 1

IdentifierTypeStateIssuer
5301008736OtherMILICENSE NUMBER

Other names 1

  • Community Care Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hackley Community Care31 organizations share this tax ID, including this one
Part of
Hackley Community Care

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445299200000",
    "number": "1114107547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 BAKER ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442157",
            "telephone_number": "231-737-9510",
            "fax_number": "231-739-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 BAKER ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442157",
            "telephone_number": "231-737-9510",
            "fax_number": "231-739-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKLEY COMMUNITY CARE CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HACKLEY COMMUNITY CARE CENTER",
        "enumeration_date": "2007-11-14",
        "last_updated": "2015-10-20",
        "status": "A",
        "authorized_official_last_name": "BLONDIN",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "CHIEF FINANCE OFFICE",
        "authorized_official_telephone_number": "231-733-6657",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301008736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "5301008736",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; 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.