NPIMap

Organization Active NPI

West Michigan Cancer Center

  • Community/Retail Pharmacy
  • Kalamazoo, MI
National Provider Identifier
1730506510
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301010374 Issued in MI
Legal business name
WEST MICHIGAN CANCER CENTER
Doing business as
West Michigan Cancer Center Retail Pharmacy
Practice address
200 N Park St
Kalamazoo, MI 49007-3731
Phone
(269) 384-8626
Fax
(269) 373-7478
NPI assigned
Mar 18, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Authorized official

Name
Joseph Mirro
Title
Cmo
Phone
(269) 382-2500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 5301010374 MI Primary

Addresses

Primary practice location

200 N Park St
Kalamazoo, MI 49007-3731

Mailing address

200 N Park St
Kalamazoo, MI 49007-3731
Phone (269) 384-8626

Other identifiers 2

IdentifierTypeStateIssuer
1730506510MedicaidMI
2144774OtherPK

Other names 1

  • West Michigan Cancer Center Retail Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
West Michigan Cancer Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1730506510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073731",
            "telephone_number": "269-384-8626",
            "fax_number": "269-373-7478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073731",
            "telephone_number": "269-384-8626",
            "fax_number": "269-373-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST MICHIGAN CANCER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-18",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "MIRRO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "269-382-2500"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730506510",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2144774",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Michigan Cancer Center Retail Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.