Organization Active NPI

Bronson City Pharmacy LLC

Doing business as Bronson City Pharmacy

  • Community/Retail Pharmacy
  • Bronson, MI
National Provider Identifier
1528616273
Registry record updated Dec 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
BRONSON CITY PHARMACY LLC
Doing business as
Bronson City Pharmacy
Practice address
625 E Chicago St
Bronson, MI 49028-1322
Phone
(517) 610-7082
NPI assigned
Aug 27, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2024

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

Authorized official

Name
Suchitkumar ShahNPI 1215171699
Title
President
Phone
(517) 858-1122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

625 E Chicago St
Bronson, MI 49028-1322

Mailing address

625 E Chicago St
Bronson, MI 49028-1322
Phone (517) 858-1122

Other names 1

  • BRONSON CITY PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200616002505 MI Part B Supplier - Pharmacy 4183046378 Practice locations: Bronson, MI

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2217527Bronson City Pharmacy625 E Chicago Street, Bronson, MI 49028Certificate of waiverMar 21, 2027

National Provider Directory

National Provider Directory

Locations

625 E Chicago St
Bronson, MI 49028
Phone (517) 858-1122

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734998400000",
    "number": "1528616273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E CHICAGO ST",
            "city": "BRONSON",
            "state": "MI",
            "postal_code": "490281322",
            "telephone_number": "517-858-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E CHICAGO ST",
            "city": "BRONSON",
            "state": "MI",
            "postal_code": "490281322",
            "telephone_number": "517-610-7082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONSON CITY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-27",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SUCHITKUMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-858-1122"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRONSON CITY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BRONSON CITY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bronson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2024; 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.