NPIMap

Organization Active NPI

Central Pharmacy-Owosso LLC

  • Community/Retail Pharmacy
  • Owosso, MI
National Provider Identifier
1851337760
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301010567 Issued in MI
Legal business name
CENTRAL PHARMACY-OWOSSO LLC
Doing business as
Central Pharmacy-Owosso LLC
Practice address
111 N Washington St
Owosso, MI 48867-2819
Phone
(989) 725-1344
Fax
(989) 729-0109
NPI assigned
Jun 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Authorized official

Name
David Larner, RPHNPI 1750493094
Title
Member
Phone
(517) 410-8581

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 5301010567 MI Primary

Addresses

Primary practice location

111 N Washington St
Owosso, MI 48867-2819

Mailing address

111 N Washington St
Owosso, MI 48867-2819
Phone (989) 725-1344

Other identifiers 2

IdentifierTypeStateIssuer
4073892MedicaidMI
2147805OtherPK

Other names 1

  • Central Pharmacy-Owosso LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20141119000950 MI DME Supplier - Pharmacy 8820210263 Practice locations: Owosso, MI
O20161006001384 MI Part B Supplier - Mass Immunization (Roster Biller Only) 8820210263 Practice locations: Owosso, MI
O20221021002308 MI Part B Supplier - Independent Clinical Laboratory 8820210263 Practice locations: Owosso, MI

National Provider Directory

National Provider Directory
Tax ID family
Central Pharmacy-Owosso2 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 2

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": "1150761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1851337760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N WASHINGTON ST",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488672819",
            "telephone_number": "989-725-1344",
            "fax_number": "989-729-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N WASHINGTON ST",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488672819",
            "telephone_number": "989-725-1344",
            "fax_number": "989-729-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PHARMACY-OWOSSO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-20",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "LARNER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "517-410-8581",
        "authorized_official_credential": "RPH"
    },
    "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": "5301010567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4073892",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147805",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Pharmacy-Owosso LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Pharmacy-Owosso LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Owosso, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.