Perry Drug Stores Inc and Subsidiaries

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301005244 Issued in MI

Legal business name

PERRY DRUG STORES INC AND SUBSIDIARIES

Practice address

1201A South Division Street
Traverse City, MI 49684-4426

Phone

(231) 929-0526

NPI assigned

Aug 29, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer Zorek

Title

Manager Online Adjudication

Phone

(717) 975-5937

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• RITE AID PHARMACY 04495 Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 4

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

• Robert Brzezinski, R.PH.

  • Pharmacist
  • Traverse City, MI
  • NPI 1285925180
  NPD (past)
• Matthew Burns Nielsen, PHARMD

  • Pharmacist
  • Traverse City, MI
  • NPI 1144697848
  NPD (past)
• Adam G Schoech

  • Pharmacist
  • Traverse City, MI
  • NPI 1265086177
  NPD (past)
• Katheryn Rae Wallison

  • Pharmacy Technician
  • Traverse City, MI
  • NPI 1760173306
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237161600000",
    "number": "1467561910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEWBERRY COMMONS",
            "city": "ETTERS",
            "state": "PA",
            "postal_code": "173199363",
            "telephone_number": "717-761-2633",
            "fax_number": "717-975-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201A SOUTH DIVISION STREET",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844426",
            "telephone_number": "231-929-0526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY DRUG STORES INC AND SUBSIDIARIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2009-03-16",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER ONLINE ADJUDICATION",
        "authorized_official_telephone_number": "717-975-5937"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301005244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2345709",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2345709",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 04495",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joanne Peregrine
• Katie Jane Perez
• Jennifer Marie Perkins, D.O.
• Philip Lee Perkins, MD
• Arianna E Apelgren Perra, PSY.D.
• Amber M Perry
• Christina Perry
• Alexander Zachary Persyn, PA-C
• Peter Foster Fishman Psy D PC
• Peter T McAndrews III DO, PC

• 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 Mar 16, 2009; 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.