Kentwood Pharmacy

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

5901008943 Issued in MI

Legal business name

KENTWOOD PHARMACY

Practice address

116 N Mill St
Saint Louis, MI 48880-1521

Phone

(989) 681-6633

Fax

(989) 681-6644

NPI assigned

Aug 18, 2008

Organization subpart

No

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

Authorized official

Name

Mark Downer

Title

Accounts Payable

Phone

(616) 827-9100

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Kentwood Pharmacy Doing business as

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1760638019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 44TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495129090",
            "telephone_number": "616-827-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 N MILL ST",
            "city": "SAINT LOUIS",
            "state": "MI",
            "postal_code": "488801521",
            "telephone_number": "989-681-6633",
            "fax_number": "989-681-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTWOOD PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-18",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "DOWNER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "ACCOUNTS PAYABLE",
        "authorized_official_telephone_number": "616-827-9100"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MI",
            "license": "5901008943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2372263",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kentwood Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erika Maria Huntoon
• Isabella Citizens for Health, Inc.
• Isabella Citizens for Health, Inc.
• Thomas Allen Jones, PTA
• Nevada Noelle Kennedy-Hansen, FNP-C
• Ahmad Zia Khorrami, D.C.
• Kubin'S Quality Home Furnishings
• Cheryl Lahti I
• Caroline Lee Lecureux, OTRL
• Rachel D Long, NP

• Long Term Care Pharmacy in Saint Louis, MI
• Providers in Saint Louis, MI by specialty
• Long Term Care Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.