DIVINICARE LLC (NPI# 1114345907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1114345907 |
Entity Type | Organization |
Organization Name | DIVINICARE LLC |
Other Organization Name | DIVINICARE |
Practice Address |
868 Michigan Ave Ste A Baldwin MI 49304-7123 |
Mailing Address |
Po Box 310 Suite A Baldwin MI 49304-0310 |
Practice Telephone | 2317454697 |
Practice Fax Number | 2317458640 |
Mailing Telephone | 2317454697 |
Mailing Fax Number | 2317458640 |
Enumeration Date | 2014-03-31 |
Last Update Date | 2015-06-10 |
Authorized Official Name | MATTHEW KRAWCZAK (RPH/OWNER) |
Authorized Official Telephone | 2317454697 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
5301010379 | MI | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PK | 2146577 | 01 |
Other Name | Type Code |
---|---|
DIVINICARE | Doing Business As Name - Organization |
Street Address |
868 MICHIGAN AVE STE A |
City | BALDWIN |
State | MI |
Zip Code | 49304-7123 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154592285 | Professional Dental Associates PC | Dentist | 888 Michigan Ave, Baldwin, MI 49304 | 2008-03-17 |
1437250941 | Pamela Sue Alley | Nurse Practitioner | 1234 Washington Ave, Vision of Health, Baldwin, MI 49304 | 2006-09-26 |
1902308463 | Baldwin Family Health Care | Clinic/Center | 1101 Washington St, Baldwin, MI 49304 | 2018-03-01 |
1528499233 | Lisa Joan West | Nurse Practitioner | 1615 Michigan Ave, Baldwin, MI 49304 | 2013-12-05 |
1578713798 | Tracy Lynne Moody | Nurse Practitioner | 1615 Michigan Ave, Baldwin, MI 49304 | 2008-09-24 |
1801016613 | Baldwin Family Health Care | Clinic/Center | 525 4th St, Baldwin, MI 49304 | 2007-04-26 |
1932248143 | John Carl Hodges | Counselor | 1615 Michigan Ave, Baldwin, MI 49304 | 2007-02-05 |
1467468819 | Maurice James Sutton | Dentist | 1615 Michigan Ave, Balduoin, MI 49304 | 2006-07-31 |
1376559724 | Oliver D Grin | Neurological Surgery | 1615 Michigan Ave, Baldwin, MI 49304 | 2006-07-31 |
1508891813 | Stephen Kozak | Dentist | 1615 Michigan Ave, Baldwin, MI 49304 | 2006-07-12 |
Find all providers in zip 49304 |
Taxonomy Code | 3336L0003X |
Grouping | Suppliers |
Classification | Pharmacy |
Specialization | Long Term Care Pharmacy |
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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1609832500 | Rasmussen Village Pharmacy, Inc. | Pharmacy | 840 Main St, Baldwin, WI 54002-0015 | 2006-04-21 |
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1710520143 | H & L Drugs Inc | Pharmacy | 1455 S Lapeer Rd Ste 101, Lake Orion, MI 48360-1468 | 2019-10-17 |
1225688229 | Guardian Pharmacy of Grand Rapids, LLC | Pharmacy | 2930 29th St Se, Grand Rapids, MI 49512-1723 | 2019-09-12 |
1457905259 | Senior Care Rx LLC | Pharmacy | 24293 Telegraph Rd Ste 130, Southfield, MI 48033-7924 | 2019-07-30 |
1063071637 | Smart Rx LLC | Pharmacy | 25464 Van Born Rd, Dearborn Heights, MI 48125 | 2019-06-07 |
1457812117 | Pharmtek LLC | Pharmacy | 3307 Orchard Lake Rd, Keego Harbor, MI 48320-1308 | 2019-03-26 |
1801350772 | Prestige Specialty Pharmacy 2 | Pharmacy | 31700 Van Dyke Ave Ste B, Warren, MI 48093-7949 | 2019-01-24 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.