PENNOCK PHARMACY (NPI# 1538426093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538426093 |
| Entity Type | Organization |
| Organization Name | PENNOCK PHARMACY |
| Other Organization Name | PENNOCK PHARMACY - GUN LAKE |
| Practice Address |
12851 W M 179 Hwy Wayland MI 49348-9318 |
| Practice Telephone | 2699458050 |
| Practice Fax Number | 2699458048 |
| Mailing Telephone | 2699458050 |
| Mailing Fax Number | 2699458048 |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2015-10-13 |
| Authorized Official Name | AMANDA RISNER (CERTIFIED PHARMACY TECHNICIAN) |
| Authorized Official Telephone | 2699451212 |
| Authorized Official Credential | R. PH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301009800 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2134742 | 01 |
| Other Name | Type Code |
|---|---|
| Pennock Pharmacy - Gun Lake | Doing Business As Name - Organization |
| Street Address |
12851 W M 179 HWY |
| City | WAYLAND |
| State | MI |
| Zip Code | 49348-9318 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457459950 | Lawrence S Hawkins | Family Medicine | 12851 W M 179 Hwy, Wayland, MI 49348-9318 | 2006-09-20 |
| 1205281045 | Pennock Hospital | Nurse Practitioner | 12851 W M 179 Hwy, Wayland, MI 49348-9318 | 2016-04-29 |
| 1801250907 | Pennock Hospital | Clinic/Center | 12851 W M 179 Hwy, Wayland, MI 49348-9318 | 2016-04-05 |
| 1639583495 | Andrew Stanley | Family Medicine | 12851 W M 179 Hwy, Wayland, MI 49348-9318 | 2014-06-19 |
| 1073940896 | Tracy Texter | Nurse Practitioner | 12851 W M 179 Hwy, Wayland, MI 49348-9318 | 2013-10-11 |
| 1699055194 | Rebecca G Eckert | Nurse Practitioner | 12851 W M 179 Hwy, Wayland, MI 49348 | 2011-08-28 |
| 1760775274 | Shelley Heijerman | Nurse Practitioner | 12851 W M 179 Hwy, Wayland, MI 49348-9318 | 2011-05-17 |
| 1689773301 | Sarah E Verburg | Nurse Practitioner | 12851 W M 179 Hwy, Wayland, MI 49348-9318 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215447214 | Alexandra Jo Obetts | Occupational Therapist | 145 S. Main Suite 4, Wayland, MI 49348 | 2017-10-04 |
| 1821450404 | Samantha Chilcote Ritenburgh | Psychologist | 2730 S Patterson Rd, Wayland, MI 49348 | 2016-03-23 |
| 1629222864 | Susan Mccourt | Physical Therapist | 709 W. Superior, Wayland, MI 49348 | 2008-11-14 |
| 1720204126 | Christine Laura Ackermann | Dentist | 12715 W M-179 Hwy, Wayland, MI 49348 | 2007-04-17 |
| 1811069099 | Adam Greenman | Chiropractor | 135 E. Superior St., Wayland, MI 49348 | 2006-11-14 |
| 1942392337 | Robert Michael Rowe | Pharmacist | 300 Reno Drive, Wayland, MI 49348 | 2006-09-29 |
| 1447223995 | Ronald Angelo House II | Chiropractor | 135 E Superior St, Wayland, MI 49348 | 2006-02-07 |
| 1023100419 | Michael Shannon Shea | Pharmacist | 300 Reno Dr, Wayland Village Pharmacy, Wayland, MI 49348 | 2006-09-29 |
| 1295769123 | Peter Anthony Post | Physical Therapist | 145 S Main St, Wayland, MI 49348 | 2006-07-10 |
| 1932746658 | Elizabeth Sidney Baughman | Social Worker | 517 W Elm St, Wayland, MI 49348-1079 | 2019-12-01 |
| Find all providers in zip 49348 | ||||
| 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] |
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| 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.