NPIMap

Organization Active NPI

SDS Pharmacy Inc

Doing business as Capac Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Capac, MI
National Provider Identifier
1346358710
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301006496 Issued in MI
Legal business name
SDS PHARMACY INC
Doing business as
Capac Pharmacy, Inc.
Practice address
136 N Main Street
Capac, MI 48014
Phone
(810) 395-2336
Fax
(810) 395-9015
NPI assigned
Aug 27, 2006
Last updated
Mar 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Authorized official

Name
Mr. Scot Douglas SheldonNPI 1477683449
Title
President
Phone
(810) 387-4244

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301006496 MI Primary

Addresses

Primary practice location

136 N Main Street
Capac, MI 48014

Mailing address

43155 W 9 Mile Rd
Novi, MI 48375-4190

Other names 1

  • Capac Pharmacy, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160912002209 MI Part B Supplier - Mass Immunization (Roster Biller Only) 7315233632 1 other NPI on this enrollment
Practice locations: Yale, MI

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

25 S Main St
Yale, MI 48097
Phone (810) 387-4244

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capac Pharmacy, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Capac, MI

Sources for this page

  • 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.