Plymouth Towne Care Pharmacy Inc

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

054020404 Issued in IL

Legal business name

PLYMOUTH TOWNE CARE PHARMACY INC

Doing business as

Peoples Drug Store

Practice address

301 N Michigan St
Plymouth, IN 46563-1735

Phone

(574) 936-3167

Fax

(574) 936-6155

NPI assigned

Jul 18, 2017

Last updated

Jul 19, 2018By 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

Jessica Burgess

Title

Manager

Phone

(574) 936-3167

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• PEOPLES DRUG STORE Doing business as

Locations

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1770006173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N MICHIGAN ST",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465631735",
            "telephone_number": "574-936-3167",
            "fax_number": "574-936-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N MICHIGAN ST",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465631735",
            "telephone_number": "574-936-3167",
            "fax_number": "574-936-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLYMOUTH TOWNE CARE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-18",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "574-936-3167"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IN",
            "license": "60006496A",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "WI",
            "license": "1929-43",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "IL",
            "license": "054020404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2170772",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100309590B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEOPLES DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Long Term Care Pharmacy in Plymouth, IN
• Providers in Plymouth, IN by specialty
• Long Term Care Pharmacy in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.

Verify at the official NPI Registry.