NPIMap

Organization Active NPI

Kentwood Pharmacy

  • Long Term Care Pharmacy
  • Shepherd, MI
National Provider Identifier
1841446192
Registry record updated Sep 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
5301008951 Issued in MI
Legal business name
KENTWOOD PHARMACY
Doing business as
Kentwood Pharmacy
Practice address
257 W Wright Ave
Shepherd, MI 48883-2502
Phone
(616) 827-9100
NPI assigned
Aug 18, 2008
Last updated
Sep 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2009

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

Authorized official

Name
Linda Malinowski
Title
Controller
Phone
(616) 827-9100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X
Long Term Care Pharmacy 3336L0003X 5301008951 MI Primary

Addresses

Primary practice location

257 W Wright Ave
Shepherd, MI 48883-2502

Mailing address

2480 44TH St SE
Kentwood, MI 49512-9090

Other identifiers 1

IdentifierTypeStateIssuer
2372251OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Kentwood Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kentwood Pharmacy LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251849600000",
    "number": "1841446192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 44TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495129090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 W WRIGHT AVE",
            "city": "SHEPHERD",
            "state": "MI",
            "postal_code": "488832502",
            "telephone_number": "616-827-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTWOOD PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-18",
        "last_updated": "2009-09-02",
        "status": "A",
        "authorized_official_last_name": "MALINOWSKI",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "616-827-9100"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MI",
            "license": "5301008951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2372251",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kentwood Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shepherd, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; 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.