Active NPI
Northwest Synergy Inc
- Pharmacist
- Interlochen, MI
National Provider Identifier
1861544868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5301006774
- Legal business name
- NORTHWEST SYNERGY INC
- Practice address
- 2100 Old Grade Ave.
Box 67
Interlochen, MI 49643 - Phone
- (231) 276-9014
- NPI assigned
- Jan 18, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Richard Andrews Macrae, RPH
- Title
- Co Owner
- Phone
- (231) 352-4471
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5301006774 | MI | Primary |
Addresses
Primary practice location
2100 Old Grade Ave.
Box 67
Interlochen, MI 49643
Mailing address
2100 Old Grade Ave.
Box 67
Interlochen, MI 49643
Phone (231) 276-9014
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2317382 | Medicaid | MI | |
| 2317382 | Other | NABP |
Other names 1
- COMMUNITY DRUG OF INTERLOCHEN
National Provider Directory
National Provider Directory- Tax ID family
- Community Drug Benzonia
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pharmacy
- Benzonia, MI
- NPI 1699829556
Locations
2100 Old Grade Ave
#67
Interlochen, MI 49643
Phone (231) 276-9014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1861544868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 OLD GRADE AVE.",
"address_2": "BOX 67",
"city": "INTERLOCHEN",
"state": "MI",
"postal_code": "49643",
"telephone_number": "231-276-9014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 OLD GRADE AVE.",
"address_2": "BOX 67",
"city": "INTERLOCHEN",
"state": "MI",
"postal_code": "49643",
"telephone_number": "231-276-9014"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHWEST SYNERGY INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-18",
"last_updated": "2023-03-07",
"status": "A",
"authorized_official_last_name": "MACRAE",
"authorized_official_first_name": "RICHARD",
"authorized_official_middle_name": "ANDREWS",
"authorized_official_title_or_position": "CO OWNER",
"authorized_official_telephone_number": "231-352-4471",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "MI",
"license": "5301006774",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2317382",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP",
"identifier": "2317382",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "COMMUNITY DRUG OF INTERLOCHEN",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Interlochen, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.