Pgpa LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301006602 Issued in MI

Legal business name

PGPA LLC

Doing business as

PGPA Pharmacy

Practice address

3544 Meridian Crossings
Ste 120
Okemos, MI 48864-6025

Phone

(517) 381-7472

Fax

(517) 381-8724

NPI assigned

Nov 17, 2006

Organization subpart

No

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

Authorized official

Name

Lynne Adrianroberts

Title

Partner

Phone

(517) 381-7472

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• PGPA Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552003200000",
    "number": "1548334063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3544 MERIDIAN CROSSINGS",
            "address_2": "STE 120",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646025",
            "telephone_number": "517-381-7472",
            "fax_number": "517-381-8724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3544 MERIDIAN CROSSINGS",
            "address_2": "STE 120",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488646025",
            "telephone_number": "517-381-7472",
            "fax_number": "517-381-8724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PGPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2019-03-08",
        "status": "A",
        "authorized_official_last_name": "ADRIANROBERTS",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "517-381-7472"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301006602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2043986",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3368731",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00668987",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PGPA Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PGPA Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kirby Kenneth Perrault, DC
• Dennis James Perry, M.D.
• Nicolas Pertusi
• Rachael Peters
• Thomas Petroff, DO
• Jacqueline Pham
• Alexis M Phillips, NP
• Colleen Patricia Phillips, OD
• Stephen Adrian Phillips, DDS
• Jenny Phung

• Community/Retail Pharmacy in Okemos, MI
• Providers in Okemos, 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 Mar 8, 2019; 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.