NPIMap

Organization Active NPI

Mikes Family Pharmacy Inc

Doing business as Mikes Family Pharmacy

  • Community/Retail Pharmacy
  • Montague, MI
National Provider Identifier
1467740688
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301009749 Issued in MI
Legal business name
MIKES FAMILY PHARMACY INC
Doing business as
Mikes Family Pharmacy
Practice address
8718 Water St Ste a
Montague, MI 49437-1204
Phone
(231) 894-8633
Fax
(231) 893-3530
NPI assigned
Jul 21, 2011
Last updated
Oct 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Authorized official

Name
Michael CookNPI 1598738221
Title
Owner
Phone
(231) 740-6025

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301009749 MI Primary

Addresses

Primary practice location

8718 Water St Ste a
Montague, MI 49437-1204

Mailing address

8718 Water St
Suite a
Montague, MI 49437-1204
Phone (231) 894-8633

Other identifiers 2

IdentifierTypeStateIssuer
1467740688MedicaidMI
2375752OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • MIKES FAMILY PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

8718 Water St
#A
Montague, MI 49437
Phone (231) 894-8633

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351123200000",
    "number": "1467740688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8718 WATER ST",
            "address_2": "SUITE A",
            "city": "MONTAGUE",
            "state": "MI",
            "postal_code": "494371204",
            "telephone_number": "231-894-8633",
            "fax_number": "231-893-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8718 WATER ST STE A",
            "city": "MONTAGUE",
            "state": "MI",
            "postal_code": "494371204",
            "telephone_number": "231-894-8633",
            "fax_number": "231-893-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKES FAMILY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-21",
        "last_updated": "2012-10-25",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-740-6025"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467740688",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2375752",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIKES FAMILY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montague, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.