Midtowne Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009298 Issued in MI

Legal business name

MIDTOWNE PHARMACY

Practice address

555 Midtowne St NE
Suite 103
Grand Rapids, MI 49503-5729

Phone

(616) 554-1964

NPI assigned

Apr 13, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Kim Mulder

Title

Ceo

Phone

(616) 827-9100

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280448000000",
    "number": "1700102993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 MIDTOWNE ST NE",
            "address_2": "SUITE 103",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035729",
            "telephone_number": "616-554-1964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MIDTOWNE ST NE",
            "address_2": "SUITE 103",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035729",
            "telephone_number": "616-554-1964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWNE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-13",
        "last_updated": "2010-07-30",
        "status": "A",
        "authorized_official_last_name": "MULDER",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "616-827-9100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope Louise Mickelson, NP
• Megan O Middlemiss
• Hannah Richard Middleton, PA-C
• Maria Midena, DNP, CRNA
• Sara Lynn Midkiff
• Midtowne Smiles PC
• Midwest Counseling Services PLC
• Midwest Divine Home Help Services, LLC
• Midwest Institute of Health PC
• Midwest Rockets HH, LLC

• 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 Jul 30, 2010; 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.