Wakefield Pharmacy Enterprises LTD

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

WAKEFIELD PHARMACY ENTERPRISES LTD

Doing business as

Wakefield Pharmacy

Practice address

408 Sunday Lake St
Wakefield, MI 49968-1338

Phone

(906) 229-5966

Fax

(906) 229-5707

NPI assigned

Jul 30, 2006

Last updated

Sep 4, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathy Rocco, RPH

Title

Owner

Phone

(906) 229-5966

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• WAKEFIELD PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

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.

• Cindy Rand

  • Pharmacist
  • Wakefield, MI
  • NPI 1053076000
  NPD
• James Emil Rocco, M.D.

  • Internal Medicine Physician
  • Wakefield, MI
  • NPI 1710075346
  NPD (past)

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1528073145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 171",
            "city": "WAKEFIELD",
            "state": "MI",
            "postal_code": "499680171",
            "telephone_number": "906-229-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 SUNDAY LAKE ST",
            "city": "WAKEFIELD",
            "state": "MI",
            "postal_code": "499681338",
            "telephone_number": "906-229-5966",
            "fax_number": "906-229-5707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKEFIELD PHARMACY ENTERPRISES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "ROCCO",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "906-229-5966",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5301008317",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301008317",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "871923680",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2327953",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WAKEFIELD PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Simcoe
• Daniel Peter Tibaldo
• Tobi A Trotochaud
• Morgan Chelsea Vallejo, LPC
• Rebecca M Vencl
• Kathleen Lynn Wangelin
• Mark Ronald Wendt, LPC
• Benjamin Wojcik
• Christopher Jay Wuorinen, MA., CCC-SLP
• Monica Zak, LLBSW

• Community/Retail Pharmacy in Wakefield, MI
• Providers in Wakefield, 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 Sep 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.