Gateway Pharmacy of Clare Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301007820 Issued in MI

Legal business name

GATEWAY PHARMACY OF CLARE INC

Practice address

1048 N McEwan St
Clare, MI 48617-1154

Phone

(989) 386-2900

Fax

(989) 386-3710

NPI assigned

Oct 8, 2005

Organization subpart

No

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

Authorized official

Name

Mr. John William Gross, RPHNPI 1215457817

Title

President

Phone

(989) 339-9008

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Gateway Pharmacy of Clare Doing business as

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

Locations

Practitioners 5

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

• John W Gross, RPH

  • Pharmacist
  • Clare, MI
  • NPI 1215457817
  NPD (past) Authorized official
• Joshua Gross, PHARMD

  • Pharmacist
  • Clare, MI
  • NPI 1053081075
  NPD (past)
• Melissa Lynn Hamilton, CPHT

  • Pharmacy Technician
  • Clare, MI
  • NPI 1679165831
  NPD (past)
• Bryan Victor Homberg, PHARMD, RPH

  • Pharmacist
  • Clare, MI
  • NPI 1336814854
  NPD (past)
• Sage Newman

  • Pharmacist
  • Clare, MI
  • NPI 1922412501
  NPD (past)

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

{
    "created_epoch": "1128729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601683200000",
    "number": "1629066204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11271 HARRISON AVE",
            "city": "FARWELL",
            "state": "MI",
            "postal_code": "486229439",
            "telephone_number": "989-339-9008",
            "fax_number": "855-855-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1048 N MCEWAN ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171154",
            "telephone_number": "989-386-2900",
            "fax_number": "989-386-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY PHARMACY OF CLARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-08",
        "last_updated": "2020-10-03",
        "certification_date": "2020-10-03",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-339-9008",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301007820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4826288",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "2365496",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Pharmacy of Clare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gateway Pharmacy of Clare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fachting Counseling Services, Inc.
• Daniel Dean Fachting, PH.D.
• Farwell Family Medicine Clinic PC
• John A Finn, O.D.
• Melody L Fitzer, M.D.
• Gateway Pharmacy of Clare, Inc.
• Steven D. Gellman, M.D.
• Bethany J Georgia, LMSW
• Kalen Denise Gerulski, MSN, FNP-BC
• Abigail Gizinski, MD

• Community/Retail Pharmacy in Clare, MI
• Providers in Clare, 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 Oct 3, 2020; 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.