Active NPI
Clarkstonrx LLC
- Community/Retail Pharmacy
- Clarkston, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- CLARKSTONRX LLC
- Practice address
- 5838 S Main St
Clarkston, MI 48346-2963 - Phone
- (248) 625-8030
- Fax
- (248) 625-9207
- NPI assigned
- Sep 27, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Andrew D Nelson
- Title
- Member
- Phone
- (248) 625-8030
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
5838 S Main St
Clarkston, MI 48346-2963
Mailing address
5838 S Main St
Clarkston, MI 48346-2963
Phone (248) 625-8030
Other names 1
- Clarkston Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191030003030 | MI | Part B Supplier - Mass Immunization (Roster Biller Only) | 7810229457 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Clarkston, MI |
| O20211230000152 | MI | DME Supplier - Pharmacy | 7810229457 | Practice locations: Clarkston, MI |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Clarkstonrx LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Clarkston, MI
- NPI 1518185685
Locations
5838 S Main St
Clarkston, MI 48346
Phone (248) 625-8030
5838 S Main St
Ste A
Clarkston, MI 48346
Phone (248) 625-8030
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Clarkston, MI
- NPI 1285947523
-
- Pharmacist
- Clarkston, MI
- NPI 1477070001
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127779200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1587340800000",
"number": "1679569362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5838 S MAIN ST",
"city": "CLARKSTON",
"state": "MI",
"postal_code": "483462963",
"telephone_number": "248-625-8030",
"fax_number": "248-625-9207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5838 S MAIN ST",
"city": "CLARKSTON",
"state": "MI",
"postal_code": "483462963",
"telephone_number": "248-625-8030",
"fax_number": "248-625-9207"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLARKSTONRX LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-27",
"last_updated": "2020-04-20",
"certification_date": "2020-04-20",
"status": "A",
"authorized_official_last_name": "NELSON",
"authorized_official_first_name": "ANDREW",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "248-625-8030"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Clarkston Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Clarkston Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Clarkston, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.