MACDONALD DRUG STORE INC (NPI# 1437105293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437105293 |
| Entity Type | Organization |
| Organization Name | MACDONALD DRUG STORE INC |
| Other Organization Name | MACDONALD DRUG STORE INC |
| Practice Address |
512 Phoenix St South Haven MI 49090-1443 |
| Mailing Address |
110 S Main St Vicksburg MI 49097-1211 |
| Practice Telephone | 2696371161 |
| Practice Fax Number | 2696392524 |
| Mailing Telephone | 2696491476 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2016-05-20 |
| Authorized Official Name | KELLY SOEKARMOEN (OWNER) |
| Authorized Official Telephone | 2696491476 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301002169 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2041741 | 01 | |
| MI | 871982298 | 05 |
| Other Name | Type Code |
|---|---|
| MACDONALD DRUG STORE INC | Doing Business As Name - Organization |
| Street Address |
512 PHOENIX ST |
| City | SOUTH HAVEN |
| State | MI |
| Zip Code | 49090-1443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255443339 | Birgit Erickson | Pharmacist | 512 Phoenix St, South Haven, MI 49090-1443 | 2006-08-31 |
| 1467568840 | Dawn Rachelle Beckwith | Pharmacy Technician | 512 Phoenix St, South Haven, MI 49090-1443 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295234490 | Katara Therapy, LLC | Social Worker | 13560 76th Street, Suite 3, South Haven, MI 49090 | 2018-02-03 |
| 1487022091 | Kevin E. Ferrell | Physician Assistant | 955 S. Bailey Avenue, South Haven, MI 49090 | 2015-09-14 |
| 1942638002 | Birdie Farley | Chore Provider | 26725 M-140 Hwy, South Haven, MI 49090 | 2013-10-28 |
| 1730514910 | Rebecca A. Bennett | Counselor | 1675 Phoenix Road, Suite 9, South Haven, MI 49090 | 2013-09-06 |
| 1902149818 | Bronson South Haven Hospital | Emergency Medicine | 970 S Bailey Ave, South Haven, MI 49090 | 2013-03-28 |
| 1265629927 | Cecilia Liz Vives Vasquez | Physical Therapist | 23701 Red Arrow Hwy, Mattawan, MI 49090 | 2007-09-26 |
| 1518089788 | Donald Jam,es Buckley | Pharmacist | 955 S Bailey, South Haven, MI 49090 | 2007-04-06 |
| 1366568966 | Norman M Maly | Dentist | 05055 Blue Star Hwy, South Haven, MI 49090 | 2007-03-22 |
| 1639264062 | Deborah Sue Distefano | Pharmacy Technician | 512 Phoenix Street, South Haven, MI 49090 | 2006-10-03 |
| 1053357897 | Stephen Earl Tolen | Chiropractor | 325 Superior St., South Haven, MI 49090 | 2006-06-21 |
| Find all providers in zip 49090 | ||||
| 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 |
|---|---|---|---|---|
| 1578513479 | Randall Scott Davis | Pharmacy | 901 S Bailey Ave Ste 3, South Haven, MI 49090-6745 | 2006-05-11 |
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| Find all providers with the same taxonomy | ||||
| City | SOUTH HAVEN |
| Zip Code | 49090 |
Please comment or provide details below to improve the information on MACDONALD DRUG STORE INC.
| 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.