Broad Street Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BROAD STREET PHARMACY, INC

Practice address

1115 W Broad St
Chesaning, MI 48616-1068

Phone

(989) 845-9355

Fax

(989) 845-9356

NPI assigned

Jun 24, 2006

Last updated

Nov 6, 2025By 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

Dr. Tamara Elizabeth MasonNPI 1346322849

Title

President

Phone

(989) 845-9355

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 2

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.

• Tamara Elizabeth Mason, PHARMD

  • Pharmacist
  • Saginaw, MI
  • NPI 1346322849
  NPD Authorized official
• Beth Ann Tomac, CPHT

  • Pharmacy Technician
  • Chesaning, MI
  • NPI 1508907569
  NPD

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1710913355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 W BROAD ST",
            "city": "CHESANING",
            "state": "MI",
            "postal_code": "486161068",
            "telephone_number": "989-845-9355",
            "fax_number": "989-845-9356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 W BROAD ST",
            "city": "CHESANING",
            "state": "MI",
            "postal_code": "486161068",
            "telephone_number": "989-845-9355",
            "fax_number": "989-845-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD STREET PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-845-9355",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2366498",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aundrea Amman
• Theodore James Billy, O.D.
• Kennedy Birchmeier
• Tracy Ann Birchmeier, PTA
• Emily Booth
• Broad Street Pharmacy, Inc
• Robin Brown, LPN
• Julie Burtch
• Susan Cacy
• Rachel C Callahan

• Community/Retail Pharmacy in Chesaning, MI
• Providers in Chesaning, 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 Nov 6, 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.