Eric M Graham – Pharmacist in Schoolcraft, MI

Key facts

NPI: 1124057500
Entity type: Individual (NPI type 1)
Primary specialty: Pharmacist 183500000X
License: 5302029799 (MI)
Practice address: 311 N Grand St
Schoolcraft, MI 49087-5110
Phone: (269) 679-2000
Fax: (269) 679-3564
NPI assigned: Jun 30, 2006
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Red Crown II Inc Community/Retail Pharmacy · Schoolcraft, MI · NPI 1457543167

NPD (past) Authorized official

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
5302029799	MI	MD	Pharmacist

Practice roles

Organization	Specialty	Status	New patients
Red Crown II Inc		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Pharmacist	183500000X	5302029799	MI	Yes

Addresses

Primary practice location

311 N Grand St
Schoolcraft, MI 49087-5110

Mailing address

311 N Grand St
Schoolcraft, MI 49087-5110
Phone (269) 679-2000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 27, 2012.

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330300800000",
    "number": "1124057500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N GRAND ST",
            "city": "SCHOOLCRAFT",
            "state": "MI",
            "postal_code": "490875110",
            "telephone_number": "269-679-2000",
            "fax_number": "269-679-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N GRAND ST",
            "city": "SCHOOLCRAFT",
            "state": "MI",
            "postal_code": "490875110",
            "telephone_number": "269-679-2000",
            "fax_number": "269-679-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ERIC",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2012-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302029799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schoolcraft, MI

All providers in Schoolcraft, MI · Pharmacist in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.