NPIMap

Organization Active NPI

Thunder Bay Community Health Service, Inc

Doing business as Thunder Bay Pharmacy

  • Community/Retail Pharmacy
  • Atlanta, MI
National Provider Identifier
1528158441
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301007563 Issued in MI
Legal business name
THUNDER BAY COMMUNITY HEALTH SERVICE, INC
Doing business as
Thunder Bay Pharmacy
Practice address
11899 M 32
Atlanta, MI 49709-9374
Phone
(989) 785-5535
Fax
(989) 785-5267
NPI assigned
Oct 13, 2006
Last updated
Apr 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Authorized official

Name
Lori WinemanNPI 1164991527
Title
Pharmacy Director
Phone
(989) 785-5535

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X 5301007563 MI Primary

Addresses

Primary practice location

11899 M 32
Atlanta, MI 49709-9374

Mailing address

PO Box 850
11899 M32
Atlanta, MI 49709-0850
Phone (989) 785-5535

Other identifiers 2

IdentifierTypeStateIssuer
2363959OtherNCPDP PROVIDER IDENTIFICATION NUMBER
2363959MedicaidMI

Other names 1

  • THUNDER BAY PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Thunder Bay Community Health Service Inc27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

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": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1528158441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "address_2": "11899 M32",
            "city": "ATLANTA",
            "state": "MI",
            "postal_code": "497090850",
            "telephone_number": "989-785-5535",
            "fax_number": "989-785-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11899 M 32",
            "city": "ATLANTA",
            "state": "MI",
            "postal_code": "497099374",
            "telephone_number": "989-785-5535",
            "fax_number": "989-785-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THUNDER BAY COMMUNITY HEALTH SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "WINEMAN",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "PHARMACY DIRECTOR",
        "authorized_official_telephone_number": "989-785-5535"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301007563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2363959",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2363959",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THUNDER BAY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.