NPIMap

Organization Active NPI

Pine Knob Pharmacy #2

  • Durable Medical Equipment & Medical Supplies
  • Clarkston, MI
National Provider Identifier
1548438724
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PINE KNOB PHARMACY #2
Practice address
5625 Water Tower PL
Suite 101
Clarkston, MI 48346-2671
Phone
(248) 625-1215
NPI assigned
Feb 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Dr. Anthony Jay Plas, PHARM.D.
Title
Manager
Phone
(248) 625-1215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

5625 Water Tower PL
Suite 101
Clarkston, MI 48346-2671

Mailing address

5625 Water Tower PL
Suite 101
Clarkston, MI 48346-2671
Phone (248) 625-1215

National Provider Directory

National Provider Directory
Tax ID family
Pine Knob Pharmacy 22 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

5625 Water Tower Pl
Ste 101
Clarkston, MI 48346
Phone (248) 625-1215

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": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1548438724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 WATER TOWER PL",
            "address_2": "SUITE 101",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462671",
            "telephone_number": "248-625-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 WATER TOWER PL",
            "address_2": "SUITE 101",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462671",
            "telephone_number": "248-625-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE KNOB PHARMACY #2",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "PLAS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "248-625-1215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.