Organization Active NPI

VC Pharmacy PLLC

Doing business as VC Pharmacy

  • Community/Retail Pharmacy
  • Waterford, MI
National Provider Identifier
1346738192
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301011385 Issued in MI
Legal business name
VC PHARMACY PLLC
Doing business as
VC Pharmacy
Practice address
7300 Highland Rd
Waterford, MI 48327-1508
Phone
(248) 618-3894
Fax
(947) 222-8976
NPI assigned
Apr 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Authorized official

Name
Babatunde Oyewumi
Title
Ceo/Owner
Phone
(248) 618-3894

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 5301011385 MI Primary
Community/Retail Pharmacy 3336C0003X
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X
Managed Care Organization Pharmacy 3336M0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

7300 Highland Rd
Waterford, MI 48327-1508

Mailing address

12903 Beech Daly Rd
Redford, MI 48239-2781
Phone (734) 833-4781

Other identifiers 1

IdentifierTypeStateIssuer
2176636OtherPK

Other names 1

  • VC Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210203000663 MI Part B Supplier - Pharmacy 9234543216 Practice locations: Waterford, MI

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545004800000",
    "number": "1346738192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12903 BEECH DALY RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482392781",
            "telephone_number": "734-833-4781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 HIGHLAND RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271508",
            "telephone_number": "248-618-3894",
            "fax_number": "947-222-8976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VC PHARMACY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-27",
        "last_updated": "2018-12-17",
        "status": "A",
        "authorized_official_last_name": "OYEWUMI",
        "authorized_official_first_name": "BABATUNDE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "248-618-3894"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301011385",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2176636",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VC Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; 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.