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COUNTRY SQUIRE DISCOUNT PHCY INC NPI 1871548610


NPI Information

NPI: 1871548610
Provider Name: COUNTRY SQUIRE DISCOUNT PHCY INC

Doing Business As: COUNTRY SQUIRE LTC PHCY

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

Address:
26 E MAIN ST
STE B
FREMONT, MI
ZIP 49412
Phone: (231) 924-2120
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COUNTRY SQUIRE DISCOUNT PHCY INC is a long term care pharmacy pharmacy in Fremont, 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. COUNTRY SQUIRE DISCOUNT PHCY INC NPI is 1871548610. The provider is registered as an organization entity type.
The provider Is Doing Business As Country Squire Ltc Phcy.

The provider's business location address is:

26 E MAIN ST
STE B
FREMONT, MI
ZIP 49412-244
Phone: (231) 924-2120
Fax: (231) 924-6310

The provider's authorized official is Judson Afman .
The authorized official title is Member and has the following contact phone number (231) 924-2120.

The enumeration date for this NPI number is 5/23/2006 and was last updated on 9/15/2010.


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
13336L0003XPharmacyLong Term Care Pharmacy53010008387MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12368264OTHERNCPDP PROVIDER IDENTIFICATION NUMBER
20751770001MEDICARE NSC

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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