Pgpa, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010603 Issued in MI

Legal business name

PGPA, LLC

Doing business as

Benton Harbor Community Pharmacy

Practice address

800 M 139
Benton Harbor, MI 49022-3881

Phone

(269) 849-8251

Fax

(269) 927-2515

NPI assigned

Nov 26, 2014

Organization subpart

No

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

Authorized official

Name

Lynne Adrian-Roberts

Title

Manager

Phone

(517) 381-7472

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Benton Harbor Community Pharmacy Doing business as

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

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1255738746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3544 MERIDIAN CROSSINGS",
            "address_2": "SUITE 120",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646025",
            "telephone_number": "517-381-7472",
            "fax_number": "517-381-8724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 M 139",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490223881",
            "telephone_number": "269-849-8251",
            "fax_number": "269-927-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PGPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-26",
        "last_updated": "2019-08-22",
        "status": "A",
        "authorized_official_last_name": "ADRIAN-ROBERTS",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "517-381-7472"
    },
    "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": "5301010603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2149003",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Benton Harbor Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Benton Harbor Community Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Perfectly Autistic, L.L.C.
• J'Brielle Sharmaine Perkins
• Eureka S Perry
• Shelly Perry, CSW
• Melissa Petersen
• Jamie Pickel
• Jerry L. Pierce
• Mary B Pierce, LLP
• Isabella Pinto
• Michelle Marie Pleadwell, LBSW

• Community/Retail Pharmacy in Benton Harbor, MI
• Providers in Benton Harbor, 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 Aug 22, 2019; 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.