Organization Active NPI

McBain Family Pharmacy PLLC

Doing business as LC Family Pharmacy

  • Community/Retail Pharmacy
  • Lake City, MI
National Provider Identifier
1689053258
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301010683 Issued in MI
Legal business name
MCBAIN FAMILY PHARMACY PLLC
Doing business as
LC Family Pharmacy
Practice address
57 N Morey Rd
Lake City, MI 49651-8585
Phone
(231) 559-0005
Fax
(231) 559-0004
NPI assigned
May 28, 2015
Last updated
Mar 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Authorized official

Name
Clayton Gilde
Title
Owner,Ao
Phone
(231) 559-0005

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 5301010683 MI Primary
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

57 N Morey Rd
Lake City, MI 49651-8585

Mailing address

PO Box 56
MC Bain, MI 49657-0056
Phone (231) 559-0005

Other identifiers 1

IdentifierTypeStateIssuer
2152214OtherPK

Other names 1

  • LC Family Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170816002583 MI Part B Supplier - Mass Immunization (Roster Biller Only) 4789956368 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lake City, MI; MC Bain, MI

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
McBain Family Pharmacy PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

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": "1432771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1689053258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 56",
            "city": "MC BAIN",
            "state": "MI",
            "postal_code": "496570056",
            "telephone_number": "231-559-0005",
            "fax_number": "231-559-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 N MOREY RD",
            "city": "LAKE CITY",
            "state": "MI",
            "postal_code": "496518585",
            "telephone_number": "231-559-0005",
            "fax_number": "231-559-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCBAIN FAMILY PHARMACY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-28",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A",
        "authorized_official_last_name": "GILDE",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_title_or_position": "OWNER,AO",
        "authorized_official_telephone_number": "231-559-0005"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010683",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2152214",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LC Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; 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.