The Pharm of Michigan

Primary specialty

PharmacyTaxonomy code 333600000X

License

5301007193 Issued in MI

Legal business name

THE PHARM OF MICHIGAN

Practice address

124 E Front St
Adrian, MI 49221-2710

Phone

(517) 265-2101

Fax

(517) 263-6074

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Michael Smith, BSPS

Title

Third Party Contract Admin

Phone

(419) 891-4991

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• PHARM PHARMACY 6102 Doing business as

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206921600000",
    "number": "1215037544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E FRONT ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492212710",
            "telephone_number": "517-265-2101",
            "fax_number": "517-263-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E FRONT ST",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492212710",
            "telephone_number": "517-265-2101",
            "fax_number": "517-263-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PHARM OF MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-03-31",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "THIRD PARTY CONTRACT ADMIN",
        "authorized_official_telephone_number": "419-891-4991",
        "authorized_official_credential": "BSPS"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301007193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01926727",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2343969",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1215037544",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2343969",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID-DME",
            "identifier": "4821951",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARM PHARMACY 6102",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danielle Templeton
• Tendercare (Michigan) Inc.
• Zachary Terrill, PHARMD, MBA
• The Healing Project, LLC
• The Mindful Matriarch L.L.C
• The Potent Planner LLC
• The Young Men'S Christian Association of Lenawee County
• Theethaye Ittiara MD PC
• Theethaye L. Ittiara, M.D., P.C.
• Therasys, Inc.

• Pharmacy in Adrian, MI
• Providers in Adrian, MI by specialty
• Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2008; 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.