Bob'S Drugs LLC
Organization Active NPI Community/Retail Pharmacy · Hesperia, MI
NPI 1801955166 · NPPES record last updated Oct 26, 2021
Key facts
- NPI
- 1801955166
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 5301002400 (MI)
- Legal business name
- BOB'S DRUGS LLC
- Practice address
- 194 N Division Ave
Hesperia, MI 49421-7500 - Phone
- (231) 854-6605
- Fax
- (231) 854-0068
- NPI assigned
- Dec 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Aaron Slate
- Title
- Pharmacy Manager
- Phone
- (231) 854-6605
Corporate family (same tax ID) 1
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210129001342 | MI | Part B Supplier - Mass Immunization (Roster Biller Only) | 0749694941 | Practice locations: Hesperia, MI |
National Provider Directory
- Tax ID family
- Bob'S Drug LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 5301002400 | MI | |
| Community/Retail Pharmacy | 3336C0003X | 5301002400 | MI | Yes |
Addresses
Primary practice location
194 N Division Ave
Hesperia, MI 49421-7500
Mailing address
PO Box 266
Hesperia, MI 49421-0266
Phone (231) 854-6605
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2311140 | Medicaid | MI | |
| 872791989 | Medicaid | MI |
Other names
- Bob's Drugs
Other providers in Hesperia, MI
- A New Beginning Afc Home
- A New Beginning Assisssted Living/ Afc Home
- Bob'S Drugs LLC
- Patrice Elaine Bobier
- Julianne Lindsey Brimmer
- Tamara Sue Brinkman
- Dianna Brown
All providers in Hesperia, MI · Community/Retail Pharmacy in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.