Portage Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054.017842 Issued in IL

Legal business name

PORTAGE PHARMACY, INC.

Practice address

7966 Lovers LN
Portage, MI 49002-4446

Phone

(269) 327-0033

Fax

(269) 327-2709

NPI assigned

Jul 5, 2006

Organization subpart

No

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

Authorized official

Name

Lawrence Curtis, R.PH.NPI 1740871607

Title

Vice President

Phone

(269) 327-0033

Specialties & licenses 7

Addresses

Other identifiers 2

Other names 1

• PORTAGE PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lawrence Dean Curtis, RPH

  • Pharmacist
  • Portage, MI
  • NPI 1740871607
  NPD Authorized official
• Purvi Peake, PHARMD

  • Pharmacist
  • Portage, MI
  • NPI 1407447436
  NPD

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1992735666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7966 LOVERS LN",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490024446",
            "telephone_number": "269-327-0033",
            "fax_number": "269-327-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7966 LOVERS LN",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490024446",
            "telephone_number": "269-327-0033",
            "fax_number": "269-327-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "CURTIS",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "269-327-0033",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301002930",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "NP000798",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "1994-43",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "NRP.022791200-03",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "035724",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054.017842",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "IN",
            "license": "64002337A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2527217",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2040070",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PORTAGE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Portage Podiatry PC
• Maria Portal Caballero
• Christine L. Porter, M.A.SPEECH PATHOLOGY
• Marie Porter
• Oscar Posada, D.C.

• Community/Retail Pharmacy in Portage, MI
• Providers in Portage, 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 Jul 19, 2018; 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.