WOODWARD DETROIT CVS LLC (NPI# 1386992204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386992204 |
| Entity Type | Organization |
| Organization Name | WOODWARD DETROIT CVS LLC |
| Other Organization Name | CVS PHARMACY # 06843 |
| Practice Address |
626 West Front St Traverse City MI 49684-2210 |
| Mailing Address |
1 Cvs Dr Box 1075- Pharmacy Enrollments Woonsocket RI 02895-6146 |
| Practice Telephone | 2319350185 |
| Mailing Telephone | (401) 765-1500 |
| Mailing Fax Number | 4017707108 |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2017-06-28 |
| Authorized Official Name | SUSAN F. COLBERT (DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017651500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | NCPDP | 2377100 | 01 |
| MI | 1386992204 | 05 | |
| MI | MEDICATE NSC | 5603870249 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY # 06843 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093181943 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 2506 Niles Ave, Saint Joseph, MI 49085-1924 | 2015-08-14 |
| 1902292881 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 1015 S Saginaw Rd, Midland, MI 48640-5642 | 2015-04-08 |
| 1073748000 | Woodward Detroit Cvs LLC | Pharmacy | 28800 Dequindre Rd, Warren, MI 48092-2466 | 2009-05-20 |
| 1619125069 | Woodward Detroit Cvs LLC | Pharmacy | 20877 Hall Rd, Macomb, MI 48044-4256 | 2008-08-28 |
| 1528216975 | Woodward Detroit Cvs LLC | Pharmacy | 2400 S Telegraph Rd, Bloomfield Hills, MI 48302-0255 | 2008-08-28 |
| 1508042524 | Woodward Detroit Cvs LLC | Pharmacy | 47330 Michigan Ave, Canton, MI 48188-2582 | 2008-01-22 |
| 1417141482 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 5057 Harvey St, Norton Shores, MI 49444-9795 | 2007-08-31 |
| 1760532089 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 5350 W Main St, Kalamazoo, MI 49009-3304 | 2007-01-11 |
| 1619027950 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 2310 Metropolitan Pkwy, Sterling Heights, MI 48310-4209 | 2007-01-11 |
| 1336221704 | Woodward Detroit Cvs LLC | Durable Medical Equipment & Medical Supplies | 35401 Warren Rd, Westland, MI 48185-6590 | 2006-10-19 |
| Street Address |
626 WEST FRONT ST |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-2210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912071374 | Thompson Pharmacy, Inc. | Pharmacy | 3850 N Long Lake Rd, Ste 101, Traverse City, MI 49684-9601 | 2006-11-20 |
| 1730291725 | Sixth Street Drugs Inc | Pharmacy | 1020 Sixth St, Traverse City, MI 49684-2302 | 2006-08-31 |
| 1447365473 | Ddm Inc | Pharmacy | 4025 Chums Village Dr, Ste A, Traverse City, MI 49684-6992 | 2006-08-20 |
| 1134205032 | Munson Medical Center | Pharmacy | 1105 Sixth St, Traverse City, MI 49684-2349 | 2006-10-31 |
| 1366557399 | Petertyl Drug Co Inc | Pharmacy | 111 E Front St, Traverse City, MI 49684-2508 | 2006-08-20 |
| 1851322846 | Kmart of Michigan Inc | Pharmacy | 1712 S Garfield Ave, Traverse City, MI 49686-4338 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961763 | Dustyn Daniel Thoney | Pharmacy | 530 Harding Ave, Iron River, MI 49935-2265 | 2020-10-27 |
| 1497355697 | Katherine Jane Cybulski | Pharmacy | 1310 Waukazoo St, Hastings, MI 49058-9559 | 2020-10-27 |
| 1043836042 | Hanan Pharmacy LLC | Pharmacy | 4600 E 14 Mile Road, Suite 2, Warren, MI 48092-1057 | 2020-06-25 |
| 1770104192 | Hazelwood Pharmacy LLC | Pharmacy | 624 E 9 Mile Rd Ste C, Hazel Park, MI 48030-1842 | 2020-04-27 |
| 1457980609 | Berkley Pharmacy LLC | Pharmacy | 28577 Schoenherr Road, Warren, MI 48088 | 2020-04-08 |
| 1669012316 | Warriors Pharmacy, Inc. | Pharmacy | 5265 Anthony Wayne Dr, Detroit, MI 48202-3947 | 2020-01-10 |
| 1457996662 | Sunrise Pharmacy, LLC | Pharmacy | 989 University Dr Ste 104, Pontiac, MI 48342-1885 | 2019-11-12 |
| 1447894019 | Nova Pharmacy | Pharmacy | 15140 Levan Rd, Suite 40, Livonia, MI 48154 | 2019-11-06 |
| 1912541673 | Wayne Pharma | Pharmacy | 974 Ford Ave, Wyandotte, MI 48192 | 2019-11-05 |
| 1639720667 | Grand Haven Pharmacy LLC | Pharmacy | 930 John R Rd Ste Pharmacy, Troy, MI 48083-4316 | 2019-09-20 |
| Find all providers with the same taxonomy | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
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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.