NPIMap

Organization Active NPI

Hackley Community Care Center, Inc

Doing business as Community Care Clinton Pharmacy

  • Community/Retail Pharmacy
  • Muskegon, MI
National Provider Identifier
1205605698
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
HACKLEY COMMUNITY CARE CENTER, INC
Doing business as
Community Care Clinton Pharmacy
Practice address
1550 Clinton St
Muskegon, MI 49442-5007
Phone
(231) 733-6910
Fax
(231) 291-1950
NPI assigned
Dec 27, 2023
Last updated
Feb 2, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
HACKLEY COMMUNITY CARE CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Authorized official

Name
Valerie Blondin
Title
Cfo
Phone
(231) 733-6657

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

1550 Clinton St
Muskegon, MI 49442-5007

Mailing address

2700 Baker St FL 3
Muskegon, MI 49444-2157
Phone (231) 737-9510

Other names 1

  • Community Care Clinton Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Hackley Community Care31 organizations share this tax ID, including this one
Part of
Hackley Community Care

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

Locations

1550 Clinton St
Muskegon, MI 49442
Phone (231) 733-6910

NPI Registry JSON

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

{
    "created_epoch": "1703635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1205605698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 BAKER ST FL 3",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494442157",
            "telephone_number": "231-737-9510",
            "fax_number": "231-739-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 CLINTON ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425007",
            "telephone_number": "231-733-6910",
            "fax_number": "231-291-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACKLEY COMMUNITY CARE CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HACKLEY COMMUNITY CARE CENTER, INC",
        "enumeration_date": "2023-12-27",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "BLONDIN",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "231-733-6657"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Clinton Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.