DIVINICARE LLC


Address: 868 Michigan Ave Ste A, Baldwin, MI 49304-7123
Phone: 2317454697

DIVINICARE LLC (NPI# 1114345907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3336L0003X Pharmacy
Specialization: Long Term Care Pharmacy
5301010379 MI Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
PK 2146577 01

Other Provider/Organization Names

Other Name Type Code
DIVINICARE Doing Business As Name - Organization

Office Location

Street Address 868 MICHIGAN AVE STE A
City BALDWIN
State MI
Zip Code 49304-7123

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 3336L0003X
Grouping Suppliers
Classification Pharmacy
Specialization Long Term Care Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1609832500 Rasmussen Village Pharmacy, Inc. Pharmacy 840 Main St, Baldwin, WI 54002-0015 2006-04-21

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1437772159 Krx Medication Consultants Pharmacy 8266 Fernwood St, Augusta, MI 49012 2020-05-28
1235751306 Ypsilanti Family Pharmacy, Inc. Pharmacy 2287 Ellsworth Rd Ste A, Ypsilanti, MI 48197-4805 2020-05-12
1366082935 Home Town Pharmacy Inc Pharmacy 1114 W South Airport Rd, Traverse City, MI 49686-4739 2020-01-13
1619510328 Great Lakes Pharmacies I Inc Pharmacy 6213 Chicago Rd Ste 200, Warren, MI 48092-1697 2019-10-25
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
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Competitor

Search similar providers

City BALDWIN
Zip Code 49304

Improve Information

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Dataset Information

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.

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