Individual provider Active NPI

Justin Michael Comeau, BSPS, PHARMD

  • Pharmacist
  • Bad Axe, MI
National Provider Identifier
1194121194
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302040158 Issued in MI
Practice address
1100 S Van Dyke Rd
Inpatient Pharmacy
Bad Axe, MI 48413-9615
Phone
(989) 269-1531
Fax
(989) 269-2320
NPI assigned
Nov 18, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302040158 MI Primary

Addresses

Primary practice location

1100 S Van Dyke Rd
Inpatient Pharmacy
Bad Axe, MI 48413-9615

Mailing address

1100 S Van Dyke Rd
Inpatient Pharmacy
Bad Axe, MI 48413-9615
Phone (989) 269-1531

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302040158MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1416268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1194121194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S VAN DYKE RD",
            "address_2": "INPATIENT PHARMACY",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484139615",
            "telephone_number": "989-269-1531",
            "fax_number": "989-269-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S VAN DYKE RD",
            "address_2": "INPATIENT PHARMACY",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484139615",
            "telephone_number": "989-269-1531",
            "fax_number": "989-269-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMEAU",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "BSPS, PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-18",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302040158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bad Axe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; 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.