Wayland Village Drug Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301004420 Issued in MI

Legal business name

WAYLAND VILLAGE DRUG INC

Practice address

300 Reno Dr
Wayland, MI 49348-1277

Phone

(269) 792-6223

Fax

(269) 792-6349

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Micheal Shea, B.S. PHARMACY

Title

Owner

Phone

(269) 792-6223

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• WAYLAND VILLAGE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

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

• Andy Mai, PHARM.D

  • Pharmacist
  • Grandville, MI
  • NPI 1609299189
  NPD
• Robert Michael Rowe, RPH

  • Pharmacist
  • Wayland, MI
  • NPI 1942392337
  NPD (past)
• Michael Shannon Shea, RPH

  • Pharmacist
  • Wayland, MI
  • NPI 1023100419
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466035200000",
    "number": "1811908320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RENO DR",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493481277",
            "telephone_number": "269-792-6223",
            "fax_number": "269-792-6349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RENO DR",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493481277",
            "telephone_number": "269-792-6223",
            "fax_number": "269-792-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYLAND VILLAGE DRUG INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2016-06-16",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "MICHEAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-792-6223",
        "authorized_official_credential": "B.S. PHARMACY"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301004420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1758774",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2039491",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WAYLAND VILLAGE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joel Patrick Veldhouse, M.D.
• Tyler Mark Veneman, DDS
• Haley Vos, PA-C
• Wayland Area Emergency Medical Services
• Wayland Area EMS
• Amanda Kay Weersma
• Elizabeth White, DDS
• Kendel Wiercinski
• Jillian Wilbur, LLMSW
• Margaret Dawn Wilkins, COTA/L

• Community/Retail Pharmacy in Wayland, MI
• Providers in Wayland, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.