Active NPI
Keith Brown
- Pharmacist
- Calumet, MI
National Provider Identifier
1265012330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302025667
- Practice address
- 56905 Station Dr
Calumet, MI 49913-2903 - Phone
- (906) 934-2336
- NPI assigned
- Apr 12, 2021
- Last updated
- Apr 12, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302025667 | MI | Primary |
Addresses
Primary practice location
56905 Station Dr
Calumet, MI 49913-2903
Mailing address
56905 Station Dr
Calumet, MI 49913-2903
Phone (906) 934-2336
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302025667 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MK Stores Inc | Current | Accepting new patients | |
| M.K. Stores, Inc | Past | Accepting new patients |
Locations
56905 Station Dr
Calumet, MI 49913
Phone (906) 934-2336
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Newberry Hometown Pharmacy
- Community/Retail Pharmacy
- Newberry, MI
- NPI 1447514385
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618185600000",
"number": "1265012330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56905 STATION DR",
"city": "CALUMET",
"state": "MI",
"postal_code": "499132903",
"telephone_number": "906-934-2336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56905 STATION DR",
"city": "CALUMET",
"state": "MI",
"postal_code": "499132903",
"telephone_number": "906-934-2336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "KEITH",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-12",
"last_updated": "2021-04-12",
"certification_date": "2021-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302025667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Calumet, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.