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BROAD STREET PHARMACY INC NPI 1952864951


NPI Information

NPI: 1952864951
Provider Name: BROAD STREET PHARMACY, INC
Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

CLIA Number: 23D2275442

Address:
1115 W BROAD ST
CHESANING, MI
ZIP 48616
Phone: (989) 845-9355
Get Directions

BROAD STREET PHARMACY, INC is a long term care pharmacy pharmacy in Chesaning, MI. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. BROAD STREET PHARMACY, INC NPI is 1952864951. The provider is registered as an organization entity type.

The provider's business location address is:

1115 W BROAD ST
CHESANING, MI
ZIP 48616-068
Phone: (989) 845-9355
Fax: (989) 845-9356

The provider's authorized official is Beth Tomac .
The authorized official title is Owner and has the following contact phone number (989) 845-9355.

The CLIA number assigned to this NPI record is 23D2275442 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/8/2019 and was last updated on 4/8/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail PharmacyNo
23336L0003XPharmacyLong Term Care PharmacyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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