Cedar Springs Pharmacy, LLC

Organization Active NPI Community/Retail Pharmacy · Cedar Springs, MI

NPI 1154944320 · NPPES record last updated May 22, 2020

Key facts

NPI
1154944320
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
CEDAR SPRINGS PHARMACY, LLC
Practice address
14111 White Creek Ave NE Ste 12
Cedar Springs, MI 49319-8170
Phone
(616) 439-2779
Fax
(616) 439-2552
NPI assigned
May 22, 2020
Organization subpart
No

Authorized official

Name
Jodi Maki, R.PH., PHARM.D.
Title
Pharmacist/Owner
Phone
(616) 439-2779

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20200930002429 MI Part B Supplier - Pharmacy 9638598279 Practice locations: Cedar Springs, MI

National Provider Directory

Locations

14111 White Creek Ave NE
Cedar Springs, MI 49319
Phone (616) 439-2779

14111 White Creek Ave NE
Ste 1
Cedar Springs, MI 49319
Phone (616) 439-2779

14111 White Creek Ave NE
Ste 12
Cedar Springs, MI 49319
Phone (616) 439-2779

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Yes

Addresses

Primary practice location

14111 White Creek Ave NE Ste 12
Cedar Springs, MI 49319-8170

Mailing address

14111 White Creek Ave NE Ste 12
Cedar Springs, MI 49319-8170

Other names

  • Cedar Springs Pharmacy Doing business as

Other providers in Cedar Springs, MI

All providers in Cedar Springs, MI · Community/Retail Pharmacy in Michigan

Sources for this page

Verify at the official NPI Registry.