Duane Waters Correctional Pharmacy

Primary specialty

Prison Health Clinic/CenterTaxonomy code 261QP2400X

Legal business name

DUANE WATERS CORRECTIONAL PHARMACY

Practice address

3857 Cooper St
Jackson, MI 49201-7547

Phone

(517) 780-5479

NPI assigned

Sep 15, 2016

Organization subpart

No

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

Authorized official

Name

Timothy Courser, RPH

Title

Director

Phone

(517) 780-5474

Specialties & licenses 1

Addresses

Other names 1

• Pharmacorr Other name

Tax ID family

Duane Waters Correctional Pharmacy4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Pharmacorr, LLC

  • Pharmacist
  • Indianapolis, IN
  • NPI 1235349622
  NPD tax ID
• Pharmacorr, LLC

  • Mail Order Pharmacy
  • Oklahoma City, OK
  • NPI 1649747841
  NPD tax ID
• Pharmacorr, LLC

  • Long Term Care Pharmacy
  • Oklahoma City, OK
  • NPI 1912586827
  NPD tax ID

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1770031957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3857 COOPER ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492017547",
            "telephone_number": "517-780-5479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3857 COOPER ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492017547",
            "telephone_number": "517-780-5479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUANE WATERS CORRECTIONAL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-15",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "COURSER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "517-780-5474",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "261QP2400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Prison Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pharmacorr",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kristin Ann Draffen, CSW
• Brett John Dragomer, PHARM.D.
• Brian Draper
• Matthew Lewis Draper, FNP-C, RN, AT, ATC
• Joseph C Drumm, DO
• Robert Stanley Duke, FNP-BC
• Courtney Dulaney, RDH
• Suada Dulellari
• Madelynn Duncan
• Dungytreei Operation Red Door, LLC

• Prison Health Clinic/Center in Jackson, MI
• Providers in Jackson, MI by specialty
• Prison Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.