Central Pharmacy- Eaton Rapids, LLC
Organization Active NPI Community/Retail Pharmacy · Eaton Rapids, MI
NPI 1295875284 · NPPES record last updated Aug 17, 2020
Key facts
- NPI
- 1295875284
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 5301000426 (MI)
- Legal business name
- CENTRAL PHARMACY- EATON RAPIDS, LLC
- Practice address
- 122-124 S Main Street
Eaton Rapids, MI 48827-1068 - Phone
- (517) 663-6811
- Fax
- (517) 663-1732
- NPI assigned
- Feb 7, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Kingsley Aboagye, PHARM.D
- Title
- Member
- Phone
- (517) 402-8256
Practitioners 2
-
Dianne Lynn Vanaken, RPH
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200706001561 | MI | Part B Supplier - Pharmacy | 8022431360 | Practice locations: Eaton Rapids, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 5301000426 | MI | Yes |
Addresses
Primary practice location
122-124 S Main Street
Eaton Rapids, MI 48827-1068
Mailing address
122-124 S Main Street
Eaton Rapids, MI 48827-1068
Phone (517) 663-6811
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2308307 | Medicaid | MI |
Other names
- Rottenbucher Pharmacy
Other providers in Eaton Rapids, MI
- Taylor K Bodell
- Kyle Robert Booher
- Joy Ellen Bowling
- Janelle Marie Brush
- Brooke Elizabeth Bubolz
- Central Pharmacy- Eaton Rapids, LLC
- Charis Kai Eleos LLC
- Khristina M Coker
- Denise Sue Colestock
- Michael Patrick Comer
All providers in Eaton Rapids, MI · Community/Retail Pharmacy in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.