Primecare Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

5301009165 Issued in MI

Legal business name

PRIMECARE PHARMACY LLC

Doing business as

Primecare Pharmacy

Practice address

3630 Gull Rd
Kalamazoo, MI 49048-1272

Phone

(269) 492-3300

NPI assigned

Aug 4, 2009

Organization subpart

No

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

Authorized official

Name

Michael Dabaja

Title

President

Phone

(269) 553-5000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Primecare Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254787200000",
    "number": "1396976692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3630 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481272",
            "telephone_number": "269-492-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481272",
            "telephone_number": "269-492-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-04",
        "last_updated": "2009-10-06",
        "status": "A",
        "authorized_official_last_name": "DABAJA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-553-5000"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MI",
            "license": "5301009165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2373037",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primecare Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Long Term Care Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; 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.