Bonita Jacque, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302023883 Issued in MI

Practice address

1250 Perry Ave
Big Rapids, MI 49307-2115

Phone

(231) 796-5252

NPI assigned

Feb 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336289719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13377 WOODLAND CT",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493079448",
            "telephone_number": "231-796-3871",
            "fax_number": "231-796-3879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 PERRY AVE",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072115",
            "telephone_number": "231-796-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUE",
        "first_name": "BONITA",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302023883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Big Rapids, MI
• Providers in Big Rapids, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.