SDS Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301006496 Issued in MI

Legal business name

SDS PHARMACY INC

Practice address

136 N Main Street
Capac, MI 48014

Phone

(810) 395-2336

Fax

(810) 395-9015

NPI assigned

Aug 27, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Scot Douglas Sheldon

Title

President

Phone

(810) 387-4244

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Capac Pharmacy, Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• SDS Pharmacy Inc

  • Community/Retail Pharmacy
  • Yale, MI
  • NPI 1093823452

  O20160912002209

  Same enrollment

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Abby Marie Brancaccio, PHARM D

  • Pharmacist
  • Matthews, NC
  • NPI 1679881189
  NPD
• Heather Bilinsky, CPHT

  • Pharmacy Technician
  • Capac, MI
  • NPI 1790154771
  NPD (past)

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458172800000",
    "number": "1346358710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43155 W 9 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483754190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 N MAIN STREET",
            "city": "CAPAC",
            "state": "MI",
            "postal_code": "48014",
            "telephone_number": "810-395-2336",
            "fax_number": "810-395-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SDS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2016-03-17",
        "status": "A",
        "authorized_official_last_name": "SHELDON",
        "authorized_official_first_name": "SCOT",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-387-4244",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301006496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2356283",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2356283",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3293130",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capac Pharmacy, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen Sue Kopka, LMSW
• Susan Kay Kraft, LMSW
• Melanie Ann Mailloux, LBSW
• Tracy Ann Matthews, LMSW
• Angela Lynn Nester, LMSW
• Amy Lynn Simpson
• St Clair County Community Mental Health Authority
• St Clair County Community Mental Health Sud Services - Capac
• Marney Beth Studaker-Cordner, LMSW
• Maria Guadalupe Sustaita

• Community/Retail Pharmacy in Capac, MI
• Providers in Capac, 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 Mar 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.