NPIMap

Organization Active NPI

Perry Drug Stores Inc and Subsidiaries

  • Community/Retail Pharmacy
  • Garden City, MI
National Provider Identifier
1659480101
Registry record updated Oct 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
4408 Issued in MI
Legal business name
PERRY DRUG STORES INC AND SUBSIDIARIES
Practice address
29447 Ford Road
Garden City, MI 48135-2319
Phone
(734) 525-3246
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2008

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

Authorized official

Name
Jennifer Zorek
Title
Manager Online Adjudication
Phone
(717) 975-5937

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 4408 MI Primary

Addresses

Primary practice location

29447 Ford Road
Garden City, MI 48135-2319

Mailing address

200 Newberry Commons
Etters, PA 17319-9363
Phone (717) 761-2633

Other identifiers 2

IdentifierTypeStateIssuer
2340735MedicaidMI
2340735OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • RITE AID PHARMACY 04466 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050614000979 MI Part B Supplier - Mass Immunization (Roster Biller Only) 3476597121 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

29447 Ford Rd
Garden City, MI 48135
Phone (734) 525-3246

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225065600000",
    "number": "1659480101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NEWBERRY COMMONS",
            "city": "ETTERS",
            "state": "PA",
            "postal_code": "173199363",
            "telephone_number": "717-761-2633",
            "fax_number": "717-975-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29447 FORD ROAD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352319",
            "telephone_number": "734-525-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY DRUG STORES INC AND SUBSIDIARIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-10-27",
        "status": "A",
        "authorized_official_last_name": "ZOREK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER ONLINE ADJUDICATION",
        "authorized_official_telephone_number": "717-975-5937"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "4408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2340735",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2340735",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RITE AID PHARMACY 04466",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Garden City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2008; 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.