Organization Active NPI

Tawas Pharmacy

Doing business as Tawas Super Savmor Drugs

  • Community/Retail Pharmacy
  • Tawas City, MI
National Provider Identifier
1518075985
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
TAWAS PHARMACY
Doing business as
Tawas Super Savmor Drugs
Tawas Pharmacy
Practice address
306 W Lake St
Tawas City, MI 48763-8308
Phone
(989) 362-3311
Fax
(989) 362-5733
NPI assigned
Aug 27, 2006
Last updated
Nov 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Authorized official

Name
Erik Nelson
Title
Ceo
Phone
(269) 352-2198

Specialties & licenses 1

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

Addresses

Primary practice location

306 W Lake St
Tawas City, MI 48763-8308

Mailing address

306 W Lake St
Tawas City, MI 48763-8308
Phone (989) 362-3311

Other identifiers 2

IdentifierTypeStateIssuer
2363238OtherOTHER ID NUMBER
2363238MedicaidMI

Other names 2

  • TAWAS SUPER SAVMOR DRUGS Doing business as
  • Tawas Pharmacy Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL tawasrx@gmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210126002576 MI Part B Supplier - Mass Immunization (Roster Biller Only) 0042624447 Practice locations: Tawas City, MI
O20220601000218 MI Part B Supplier - Pharmacy 0042624447 Practice locations: Tawas City, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1518075985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W LAKE ST",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487638308",
            "telephone_number": "989-362-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W LAKE ST",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487638308",
            "telephone_number": "989-362-3311",
            "fax_number": "989-362-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAWAS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ERIK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "269-352-2198"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2363238",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2363238",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "tawasrx@gmail.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "prescription data",
            "address_1": "306 W Lake St",
            "city": "Tawas City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "487638308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "TAWAS SUPER SAVMOR DRUGS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TAWAS SUPER SAVMOR DRUGS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tawas Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tawas City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.