Wank Enterprises

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301002051 Issued in MI

Legal business name

WANK ENTERPRISES

Doing business as

Eastgate Pharmacy

Practice address

2026 Boston St SE
Grand Rapids, MI 49506-4162

Phone

(616) 452-9734

Fax

(616) 452-7255

NPI assigned

Aug 18, 2006

Last updated

Oct 13, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ward Duyser

Title

Owner

Phone

(616) 452-9734

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• EASTGATE PHARMACY Doing business as

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255392000000",
    "number": "1659485639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 BOSTON ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064162",
            "telephone_number": "616-452-9734",
            "fax_number": "616-452-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 BOSTON ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064162",
            "telephone_number": "616-452-9734",
            "fax_number": "616-452-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANK ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2009-10-13",
        "status": "A",
        "authorized_official_last_name": "DUYSER",
        "authorized_official_first_name": "WARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-452-9734"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301002051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0850160001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2306187",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EASTGATE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ruoyao Wang, LLMSW
• Sheila Xingyun Wang, MD
• Tiantian Wang
• Wendi Wang, DO
• Jamie Waning, LMSW
• Stephen Francis Wanner, D.O.
• Mabel Waqar
• Anna-Marie Warbach
• Bruce Carl Warber, DDS
• Donna Warber, PHD

• Community/Retail Pharmacy in Grand Rapids, MI
• Providers in Grand Rapids, 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 13, 2009; 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.