Afav Enterprises LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009053 Issued in MI

Legal business name

AFAV ENTERPRISES LLC

Doing business as

Mattawan Village Pharmacy

Practice address

52366 N Main St
Mattawan, MI 49071-9332

Phone

(269) 668-3366

Fax

(269) 668-3439

NPI assigned

Jan 29, 2009

Last updated

Jun 19, 2009By 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

Andrea Favreau

Title

Owner

Phone

(269) 998-8320

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mattawan Village Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245369600000",
    "number": "1730327784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 203",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490710203",
            "telephone_number": "269-668-4549",
            "fax_number": "269-668-3439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52366 N MAIN ST",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490719332",
            "telephone_number": "269-668-3366",
            "fax_number": "269-668-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFAV ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-06-19",
        "status": "A",
        "authorized_official_last_name": "FAVREAU",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-998-8320"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2372465",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mattawan Village Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Mattawan, MI
• Providers in Mattawan, 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 Jun 19, 2009; 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.