The Peoples Drug Store, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

000142 Issued in MI

Legal business name

THE PEOPLES DRUG STORE, INC.

Doing business as

Peoples Drug Store

Practice address

1208 Ludington St
Escanaba, MI 49829-3539

Phone

(906) 786-1731

Fax

(906) 789-6204

NPI assigned

May 9, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Robert Lee Bodjanac, R.PH.

Title

President

Phone

(906) 786-1731

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Peoples Drug Store Doing business as

Locations

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932158599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 LUDINGTON ST",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498293539",
            "telephone_number": "906-786-1731",
            "fax_number": "906-789-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 LUDINGTON ST",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498293539",
            "telephone_number": "906-786-1731",
            "fax_number": "906-789-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEOPLES DRUG STORE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BODJANAC",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-786-1731",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "000142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1885991",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peoples Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stacey Lynn Stier, FNP-C
• Gary E. Tackman, O.D.
• Ann Tardiff
• Mark A Taylor, RPH
• Claire Eleanor Tembreull
• Madelyn Theut
• Olivia Marie Theut
• Justine Elizabeth Thompson, LLMSW
• Miranda Thompson, ABOC, NCLEC, FL LDO
• Nathyn A Thompson

• Community/Retail Pharmacy in Escanaba, MI
• Providers in Escanaba, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.