Westlake Drug, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301001583 Issued in MI

Legal business name

WESTLAKE DRUG, INC.

Practice address

8822 Portage Rd
Portage, MI 49002-6416

Phone

(269) 327-3049

Fax

(269) 327-5817

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Derek Quinn, PHARM.D.

Title

Pharmacy Manager

Phone

(269) 327-3049

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Westlake Drug Doing business as

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336435200000",
    "number": "1124049176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8822 PORTAGE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490026416",
            "telephone_number": "269-327-3049",
            "fax_number": "269-327-5817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8822 PORTAGE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490026416",
            "telephone_number": "269-327-3049",
            "fax_number": "269-327-5817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTLAKE DRUG, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2012-05-08",
        "status": "A",
        "authorized_official_last_name": "QUINN",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "269-327-3049",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "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": "MI",
            "license": "5301001583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2302533",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westlake Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Portage, MI
• Providers in Portage, 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 May 8, 2012; 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.