NPIMap

Organization Active NPI

Central Pharmacy-Mattawan LLC

  • Long Term Care Pharmacy
  • Mattawan, MI
National Provider Identifier
1811468614
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
CENTRAL PHARMACY-MATTAWAN LLC
Practice address
56109 Village Center Cir
Mattawan, MI 49071-8368
Phone
(269) 668-6801
NPI assigned
Dec 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Authorized official

Name
Mohamed A Beydoun
Title
Owner
Phone
(269) 673-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

56109 Village Center Cir
Mattawan, MI 49071-8368

Mailing address

56109 Village Center Cir
Mattawan, MI 49071-8368
Phone (269) 668-6801

Other names 1

  • MEDICINE TREE PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Central Pharmacy-Mattawan LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1811468614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56109 VILLAGE CENTER CIR",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490718368",
            "telephone_number": "269-668-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56109 VILLAGE CENTER CIR",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490718368",
            "telephone_number": "269-668-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PHARMACY-MATTAWAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-06",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "BEYDOUN",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-673-4700"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE TREE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEDICINE TREE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mattawan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.