DDM Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

DDM INC

Doing business as

MEDICAP PHARMACY

Practice address

4025 Chums Village Dr
Ste a
Traverse City, MI 49684-6992

Phone

(231) 943-0085

Fax

(231) 943-0095

NPI assigned

Aug 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Dale B Maupin, RPH

Title

Pharmacist/Owner

Phone

(231) 943-0085

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MEDICAP PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262044800000",
    "number": "1447365473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 CHURNS VILLAGE DR.",
            "address_2": "STE A.",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-943-0085",
            "fax_number": "231-943-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 CHUMS VILLAGE DR",
            "address_2": "STE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496846992",
            "telephone_number": "231-943-0085",
            "fax_number": "231-943-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DDM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2009-12-29",
        "status": "A",
        "authorized_official_last_name": "MAUPIN",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "231-943-0085",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301007598",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2364064",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2364064",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAP PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Traverse City, MI
• Providers in Traverse City, 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 Dec 29, 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.