NPIMap

Organization Active NPI

Bronson Methodist Hospital

Doing business as Bronson Pharmacy-Mattawan

  • Community/Retail Pharmacy
  • Paw Paw, MI
National Provider Identifier
1821081639
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
BRONSON METHODIST HOSPITAL
Doing business as
Bronson Pharmacy-Mattawan
Practice address
451 Health Pkwy
Paw Paw, MI 49079-8242
Phone
(269) 668-6205
Fax
(269) 668-5071
NPI assigned
Aug 26, 2005
Last updated
Mar 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Authorized official

Name
Mrs. Rebecca East
Title
Cfo
Phone
(269) 341-8536

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 5301006938 MI
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

451 Health Pkwy
Paw Paw, MI 49079-8242

Mailing address

52375 N Main St
Mattawan, MI 49071-9332
Phone (269) 668-6205

Other identifiers 1

IdentifierTypeStateIssuer
2359607OtherMINABP NUMBER

Other names 1

  • Bronson Pharmacy-Mattawan Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Davenport D S MD9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1821081639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52375 N MAIN ST",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490719332",
            "telephone_number": "269-668-6205",
            "fax_number": "269-668-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 HEALTH PKWY",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490798242",
            "telephone_number": "269-668-6205",
            "fax_number": "269-668-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRONSON METHODIST HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A",
        "authorized_official_last_name": "EAST",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "269-341-8536",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301006938",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "2359607",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bronson Pharmacy-Mattawan",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bronson Pharmacy-Mattawan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paw Paw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.