PH Copper Country Apothecaries LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010247 Issued in MI

Legal business name

PH COPPER COUNTRY APOTHECARIES LLC

Doing business as

Apothecary Houghton

Practice address

600 Macinnes Dr
Houghton, MI 49931-1144

Phone

(906) 483-1818

Fax

(906) 483-1811

NPI assigned

May 24, 2006

Organization subpart

No

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

Authorized official

Name

Charlotte Lawrence

Title

Secretary

Phone

(615) 920-7000

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Apothecary Houghton Doing business as

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• PH Copper Country Apothecaries LLC

  • Durable Medical Equipment & Medical Supplies
  • Hancock, MI
  • NPI 1235315979

  7416187349

  Same PAC ID
• PH Copper Country Apothecaries LLC

  • Community/Retail Pharmacy
  • Hancock, MI
  • NPI 1306883319

  7416187349

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

PH Copper Country LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• PH Copper Country Apothecaries LLC

  • Durable Medical Equipment & Medical Supplies
  • Hancock, MI
  • NPI 1235315979
  NPD tax ID
• PH Copper Country Apothecaries LLC

  • Long Term Care Pharmacy
  • Hancock, MI
  • NPI 1255384178
  NPD tax ID

Locations

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1114972270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 MACINNES DR",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499311144",
            "telephone_number": "906-483-1818",
            "fax_number": "906-483-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MACINNES DR",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499311144",
            "telephone_number": "906-483-1818",
            "fax_number": "906-483-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PH COPPER COUNTRY APOTHECARIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114972270",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2143559",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apothecary Houghton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Apothecary Houghton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carli Pares
• Paul a Leep MD PC
• Dorian Pello
• Amy Lynn Perfetti, LLBSW QIDP QMHP
• O'Donis J Person
• Selin Philip, PH.D.
• Phillip Pietila, DC
• Regan Pitts
• Tina Marie Ploe, NURSE PRACTITIONER
• Lawrence John Pollack, PH.D.

• Community/Retail Pharmacy in Houghton, MI
• Providers in Houghton, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.