HILL'S PHARMACY OF VICKSBURG, INC. (NPI# 1184670085) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184670085 |
| Entity Type | Organization |
| Organization Name | HILL'S PHARMACY OF VICKSBURG, INC. |
| Other Organization Name | HILL'S PHARMACY |
| Practice Address |
110 S Main St Vicksburg MI 49097-1211 |
| Practice Telephone | 2696491476 |
| Practice Fax Number | 2696494007 |
| Mailing Telephone | 2696491476 |
| Mailing Fax Number | 2696494007 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2016-09-29 |
| Authorized Official Name | KELLY SOEKARMOEN (OWNER/PHARMACIST) |
| Authorized Official Telephone | 2696491476 |
| Authorized Official Credential | R.PH. |
| Is Organization Subpart | Y |
| Parent Organization Name | HILL'S PHARMACY OF VICKSBURG, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301005736 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS MICHIGAN | 540C912930 | 01 |
| MI | 872508050 | 05 |
| Other Name | Type Code |
|---|---|
| Hill's Pharmacy | Doing Business As Name - Organization |
| Street Address |
110 S MAIN ST |
| City | VICKSBURG |
| State | MI |
| Zip Code | 49097-1211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144756610 | Pamela Hendershot | Pharmacist | 110 S Main St, Vicksburg, MI 49097-1211 | 2017-05-03 |
| 1598990525 | Kelly Ann Soekarmoen | Pharmacist | 110 S Main St, Vicksburg, MI 49097-1211 | 2009-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912132168 | Jo Lynne Kirchhoff | Pharmacist | 110 S. Main Streets, Vicksburg, MI 49097 | 2009-05-18 |
| 1558429605 | Ellen Marie Tavarone | Dentist | 602 West Prairie St, Vicksburg, MI 49097 | 2006-12-04 |
| 1598875601 | Robert L Dornbos Dds PC | Dentist | 102 S Main, Vicksburg, MI 49097 | 2006-08-30 |
| 1982680468 | Freds Super Pharmacy Inc | Pharmacy | 121 W Prairie St, Vicksburg, MI 49097 | 2005-12-16 |
| 1477853422 | South County Home Health Providers | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 115 N 3rd St, Vicksburg, MI 49097-1017 | 2010-10-25 |
| 1023214921 | Aaron C Ford | Dentist | 602 W Prairie St, Vicksburg, MI 49097-1178 | 2007-06-26 |
| 1154573392 | Family & Children Services, Inc. | Clinic/Center | 101 S Main St, Vicksburg, MI 49097-1210 | 2008-10-21 |
| 1982684916 | Robert L Dornbos | Dentist | 102 S Main St, Vicksburg, MI 49097-1211 | 2006-01-17 |
| 1326206186 | Vicksburg Optometry LLC | Eyewear Supplier (Equipment, not the service) | 124 E Prairie Street, Vicksburg, MI 49097-1257 | 2008-05-29 |
| 1417042276 | Maria Lyn Shoop Davenport | Optometrist | 124 E Prairie St, Vicksburg, MI 49097-1257 | 2006-10-04 |
| Find all providers in zip 49097 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982680468 | Freds Super Pharmacy Inc | Pharmacy | 121 W Prairie St, Vicksburg, MI 49097 | 2005-12-16 |
| 1306102470 | Freds Pharmacy of Quitman LLC | Pharmacy | 1123 Washington St, Vicksburg, MS 39183-2959 | 2012-04-03 |
| 1740412964 | Battlefield Express Drugs Incorporated | Pharmacy | 2080 S Frontage Rd, Suite 101, Vicksburg, MS 39180-5328 | 2009-08-21 |
| 1922258730 | Battlefield Clinic Drugs | Pharmacy | 2080 S Frontage Rd, Ste N, Vicksburg, MS 39180-5328 | 2008-09-29 |
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|---|---|---|---|---|
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| 1104424530 | Advance Care Rx, LLC | Pharmacy | 500 N Cass St, Berrien Springs, MI 49103-1069 | 2020-10-16 |
| 1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
| 1881292001 | Healthwatch Pharmacy Inc | Pharmacy | 1375 S Lapeer Rd Ste 102, Lake Orion, MI 48360-1421 | 2020-10-09 |
| 1225645781 | Good Choice Pharmacy LLC | Pharmacy | 6750 E 10 Mile Rd, Center Line, MI 48015-1166 | 2020-09-29 |
| 1487269122 | Canfield Pharmacy LLC | Pharmacy | 4673 Conner St, Detroit, MI 48215-2028 | 2020-09-10 |
| 1851905707 | Skidway Pharmacy LLC | Pharmacy | 1830 Greenwood Rd, Prescott, MI 48756-8627 | 2020-09-08 |
| 1023621190 | Azam Mohsen Mesleh | Pharmacy | 6811 Theisen St, Dearborn, MI 48126-1927 | 2020-08-28 |
| 1821606310 | S&k Pharmacy Inc. | Pharmacy | 1916 Davison Rd, Flint, MI 48506-4423 | 2020-07-21 |
| 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.