Organization Active NPI

Central Pharmacy - East Lansing

  • Community/Retail Pharmacy
  • East Lansing, MI
National Provider Identifier
1558736934
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301010770 Issued in MI
Legal business name
CENTRAL PHARMACY - EAST LANSING
Doing business as
Central Pharmacy - East Lansing
Practice address
248 E Saginaw St Ste 5
East Lansing, MI 48823-2760
Phone
(517) 580-4216
Fax
(517) 580-4706
NPI assigned
Dec 10, 2015
Last updated
Mar 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Authorized official

Name
Kingsley Aboagye
Title
Owner, Manager, Oa
Phone
(517) 580-4216

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 5301010770 MI Primary

Addresses

Primary practice location

248 E Saginaw St Ste 5
East Lansing, MI 48823-2760

Mailing address

248 E Saginaw St Ste 5
East Lansing, MI 48823-2760
Phone (517) 580-4216

Other identifiers 2

IdentifierTypeStateIssuer
2155860OtherPK
2381387MedicaidMI

Other names 1

  • Central Pharmacy - East Lansing Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201118001914 MI Part B Supplier - Mass Immunization (Roster Biller Only) 0840601118 Practice locations: East Lansing, MI
O20211105000128 MI Part B Supplier - Pharmacy 0840601118 Practice locations: East Lansing, MI

National Provider Directory

National Provider Directory

Locations

3340 E Lake Lansing Rd
Ste 1
East Lansing, MI 48823
Phone (517) 580-4216

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": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1558736934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 E SAGINAW ST STE 5",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488232760",
            "telephone_number": "517-580-4216",
            "fax_number": "517-580-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 E SAGINAW ST STE 5",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488232760",
            "telephone_number": "517-580-4216",
            "fax_number": "517-580-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PHARMACY - EAST LANSING",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A",
        "authorized_official_last_name": "ABOAGYE",
        "authorized_official_first_name": "KINGSLEY",
        "authorized_official_title_or_position": "OWNER, MANAGER, OA",
        "authorized_official_telephone_number": "517-580-4216"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155860",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2381387",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Pharmacy - East Lansing",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Pharmacy - East Lansing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.