Individual provider Active NPI

Steven Paul Vachon, R.PH

  • Pharmacist
  • Grand Rapids, MI
National Provider Identifier
1780748178
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302028412 Issued in MI
Practice address
200 Jefferson Ave SE
Chcwm-Lacks Pharmacy
Grand Rapids, MI 49503-4502
Phone
(616) 752-5274
Fax
(616) 752-5534
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302028412 MI Primary
Oncology Pharmacist 1835X0200X 5302028412 MI

Addresses

Primary practice location

200 Jefferson Ave SE
Chcwm-Lacks Pharmacy
Grand Rapids, MI 49503-4502

Mailing address

6659 5 Mile Rd NE
Ada, MI 49301-9723
Phone (616) 874-1031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302028412MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1780748178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6659 5 MILE RD NE",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493019723",
            "telephone_number": "616-874-1031",
            "fax_number": "616-752-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON AVE SE",
            "address_2": "CHCWM-LACKS PHARMACY",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "616-752-5274",
            "fax_number": "616-752-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACHON",
        "first_name": "STEVEN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302028412",
            "primary": true
        },
        {
            "code": "1835X0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Oncology",
            "state": "MI",
            "license": "5302028412",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.