Pioneer Family Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301008443 Issued in MI

Legal business name

PIONEER FAMILY PHARMACY INC

Practice address

412 N 5TH St
Roscommon, MI 48653-9329

Phone

(989) 275-5600

Fax

(989) 275-4707

NPI assigned

Aug 24, 2006

Organization subpart

No

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

Authorized official

Name

Richard Braidwood, RPH

Title

President

Phone

(989) 389-7277

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• PIONEER FAMILY PHARMACY #104 Doing business as

Practitioners 1

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

• Jeff Vanwormer, R. PH.

  • Pharmacist
  • Roscommon, MI
  • NPI 1629203278
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1417064650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "ROSCOMMON",
            "state": "MI",
            "postal_code": "486530547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 N 5TH ST",
            "city": "ROSCOMMON",
            "state": "MI",
            "postal_code": "486539329",
            "telephone_number": "989-275-5600",
            "fax_number": "989-275-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER FAMILY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "BRAIDWOOD",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-389-7277",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301008443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2368668",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2042339",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PIONEER FAMILY PHARMACY #104",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Partaka, OTR/L
• Teresa Pearson
• Jody Lynn Perkola, LLMSW
• Kassandra Perryman
• Sunny Leigh Phillips
• Proactive Plus Physical Therapy PLC
• R.O.O.C., Inc
• Michael Lyle Ritchie, DC
• Rite Aid of Michigan Inc
• Roscommon Family Dentistry

• Community/Retail Pharmacy in Roscommon, MI
• Providers in Roscommon, 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 May 5, 2016; 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.