NPIMap

Organization Active NPI

CFCC Specialty Pharmacy LLC

Doing business as CFCC Specialty Pharmacy

  • Pharmacy
  • Traverse City, MI
National Provider Identifier
1629520150
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
5301011031 Issued in MI
Legal business name
CFCC SPECIALTY PHARMACY LLC
Doing business as
CFCC Specialty Pharmacy
Practice address
217 S Madison St
Suite 1021 a and B
Traverse City, MI 49684-2321
Phone
(231) 392-8540
NPI assigned
Nov 1, 2016
Last updated
Nov 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Authorized official

Name
Paul KociembaNPI 1437378395
Title
Pharmacy Manager
Phone
(231) 935-5682

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 5301011031 MI Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

217 S Madison St
Suite 1021 a and B
Traverse City, MI 49684-2321

Mailing address

217 S. Madison
Suite 1021 a & B
Traverse City, MI 49684
Phone (231) 392-8540

Other names 1

  • CFCC Specialty Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

1110 Sixth St
Ste 1021
Traverse City, MI 49684
Phone (231) 392-8540

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": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479859200000",
    "number": "1629520150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 S. MADISON",
            "address_2": "SUITE 1021 A & B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-392-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 S MADISON ST",
            "address_2": "SUITE 1021 A AND B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842321",
            "telephone_number": "231-392-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CFCC SPECIALTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2016-11-23",
        "status": "A",
        "authorized_official_last_name": "KOCIEMBA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "231-935-5682"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301011031",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CFCC Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; 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.