Active NPI
Vicki Hyde, RPH
- Pharmacist
- Gwinn, MI
National Provider Identifier
1720202146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302032831
- Practice address
- 130 E State Highway M35
Gwinn, MI 49841 - Phone
- (906) 346-0104
- Fax
- (906) 346-6422
- NPI assigned
- Apr 13, 2007
- Last updated
- Aug 24, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302032831 | MI | Primary |
Addresses
Primary practice location
130 E State Highway M35
Gwinn, MI 49841
Mailing address
130 E State Highway M35
Gwinn, MI 49841-9159
Phone (906) 346-0104
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302032831 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| M K Stores Inc | Past | Accepting new patients | |
| M.K. Stores, Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Newberry Hometown Pharmacy
- Community/Retail Pharmacy
- Newberry, MI
- NPI 1447514385
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535068800000",
"number": "1720202146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 E STATE HIGHWAY M35",
"city": "GWINN",
"state": "MI",
"postal_code": "498419159",
"telephone_number": "906-346-0104",
"fax_number": "906-346-3340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 E STATE HIGHWAY M35",
"city": "GWINN",
"state": "MI",
"postal_code": "49841",
"telephone_number": "906-346-0104",
"fax_number": "906-346-6422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HYDE",
"first_name": "VICKI",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-13",
"last_updated": "2018-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302032831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gwinn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.