Active NPI
Mary Pittelko, PHARM D
- Pharmacist
- Plainwell, MI
National Provider Identifier
1568885556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302034952
- Practice address
- 1195 M 89
Plainwell, MI 49080-1135 - Phone
- (269) 685-3810
- NPI assigned
- Jan 27, 2014
- Last updated
- Feb 14, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302034952 | MI | Primary |
Addresses
Primary practice location
1195 M 89
Plainwell, MI 49080-1135
Mailing address
2707 Frederick Ave
Kalamazoo, MI 49008-2151
Phone (269) 373-9068
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302034952 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meijer Inc | Past | Accepting new patients | |
| Meijer Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487030400000",
"number": "1568885556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2707 FREDERICK AVE",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490082151",
"telephone_number": "269-373-9068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1195 M 89",
"city": "PLAINWELL",
"state": "MI",
"postal_code": "490801135",
"telephone_number": "269-685-3810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PITTELKO",
"first_name": "MARY",
"credential": "PHARM D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-27",
"last_updated": "2017-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302034952",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plainwell, MI
- Kelly Penny, PTA
- Steven Phillips, PHARMD
- Physiotherapy Associates Inc
- Pine Lake Fund
- Kim Michelle Pisano, PHARMD
- Plainwell Operations, LLC (Life Care Center of Plainwell)
- Plainwell Urgent Care Walk-in Clinic PC
- Michael Patrick Poirier, MA, ATC, CSCS
- Abraham Joshua Poston, LMSW
- Promed Healthcare (Borgess Women's Health)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.