Professional Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301004303 Issued in MI

Legal business name

PROFESSIONAL PHARMACY INC

Practice address

9175 Cherry Valley Ave SE
Caledonia, MI 49316-9746

Phone

(616) 891-1116

Fax

(616) 891-0080

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Kristin RaredonNPI 1437688025

Title

Owner

Phone

(616) 891-1116

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Professional 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 3

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

• Kristin Joy Raredon

  • Pharmacist
  • Caledonia, MI
  • NPI 1437688025
  NPD (past) Authorized official
• Lisa Diephouse, PHARMD

  • Pharmacist
  • Zeeland, MI
  • NPI 1073033726
  NPD (past)
• David Kent Hopkins, RPH

  • Pharmacist
  • Caledonia, MI
  • NPI 1578537783
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488412800000",
    "number": "1992801625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9175 CHERRY VALLEY AVE SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493169746",
            "telephone_number": "616-891-1116",
            "fax_number": "616-891-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9175 CHERRY VALLEY AVE SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493169746",
            "telephone_number": "616-891-1116",
            "fax_number": "616-891-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2017-03-02",
        "status": "A",
        "authorized_official_last_name": "RAREDON",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-891-1116"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301004303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2339679",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pinnacle Counseling and Psychotherapy Services LLC
• Elif Piromari
• Anna Marie Plant
• Erika Stremler Pott, MD
• Prevos Family Markets LLC
• Angela Mislang Quinto
• Kristen M Ranson, LMSW
• Kristin Joy Raredon
• Amanda Rasche
• Lauralee Rea, MSW

• Community/Retail Pharmacy in Caledonia, MI
• Providers in Caledonia, 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 Mar 2, 2017; 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.