Olivet Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301000875 Issued in MI

Legal business name

OLIVET PHARMACY INC

Doing business as

Olivet Pharmacy

Practice address

102 Washington St
Olivet, MI 49076-9462

Phone

(269) 749-2301

Fax

(269) 749-2301

NPI assigned

Jun 11, 2006

Last updated

Sep 27, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Glenda King, RPH

Title

President and Owner

Phone

(269) 749-2301

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• OLIVET PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317081600000",
    "number": "1124060652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 537",
            "city": "OLIVET",
            "state": "MI",
            "postal_code": "490760537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WASHINGTON ST",
            "city": "OLIVET",
            "state": "MI",
            "postal_code": "490769462",
            "telephone_number": "269-749-2301",
            "fax_number": "269-749-2301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVET PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2011-09-27",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_title_or_position": "PRESIDENT AND OWNER",
        "authorized_official_telephone_number": "269-749-2301",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301000875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1737040",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2318978",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OLIVET PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Olivet, MI
• Providers in Olivet, 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 Sep 27, 2011; 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.