Organization Active NPI

Central Pharmacy-Perry LLC

Doing business as Central Pharmacy-Perry

  • Community/Retail Pharmacy
  • Perry, MI
National Provider Identifier
1932135126
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301010568 Issued in MI
Legal business name
CENTRAL PHARMACY-PERRY LLC
Doing business as
Central Pharmacy-Perry
Practice address
150 S. Main St
Suite a
Perry, MI 48872-9703
Phone
(517) 625-8640
Fax
(517) 625-8642
NPI assigned
Jun 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 5301010568 MI Primary

Addresses

Primary practice location

150 S. Main St
Suite a
Perry, MI 48872-9703

Mailing address

PO Box 105
Perry, MI 48872-0105
Phone (517) 625-8640

Other identifiers 2

IdentifierTypeStateIssuer
2147807OtherPK
68097549363MedicaidMI

Other names 1

  • Central Pharmacy-Perry Doing business as

Medicare participation

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

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20141118002316 MI DME Supplier - Pharmacy 4880816396 Practice locations: Perry, MI
O20161010000996 MI Part B Supplier - Mass Immunization (Roster Biller Only) 4880816396 Practice locations: Perry, MI
O20221020001691 MI Part B Supplier - Independent Clinical Laboratory 4880816396 Practice locations: Perry, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2134843Central Pharmacy - Perry150 S Main Street Suite a, Perry, MI 48872Certificate of waiverAug 9, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Central Pharmacy -Perry LLC150 S Main, Perry, MI 48872-5105(517) 625-8640 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Sep 29, 2014

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597968000000",
    "number": "1932135126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 105",
            "city": "PERRY",
            "state": "MI",
            "postal_code": "488720105",
            "telephone_number": "517-625-8640",
            "fax_number": "517-625-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S. MAIN ST",
            "address_2": "SUITE A",
            "city": "PERRY",
            "state": "MI",
            "postal_code": "488729703",
            "telephone_number": "517-625-8640",
            "fax_number": "517-625-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PHARMACY-PERRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "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": "5301010568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147807",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68097549363",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Pharmacy-Perry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Central Pharmacy-Perry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Perry, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.