PENINSULA PHARMACY ESCANABA LLC (NPI# 1619408424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619408424 |
Entity Type | Organization |
Organization Name | PENINSULA PHARMACY ESCANABA LLC |
Other Organization Name | PENINSULA PHARMACY ESCANABA |
Practice Address |
2500 7th Ave S Ste 200 Escanaba MI 49829-1292 |
Mailing Address |
1414 W. Fair Ave Ste 133 Marquette MI 49855 |
Practice Telephone | 9062253902 |
Practice Fax Number | 9062262661 |
Mailing Telephone | 9062253902 |
Mailing Fax Number | 9062262661 |
Enumeration Date | 2017-03-23 |
Last Update Date | 2020-02-14 |
Authorized Official Name | DR. TYLER J JENEMA (PRESIDENT) |
Authorized Official Telephone | 9062253902 |
Authorized Official Credential | PHARM.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers | ||
Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
Other Name | Type Code |
---|---|
Peninsula Pharmacy Escanaba | Doing Business As Name - Organization |
Street Address |
2500 7TH AVE S STE 200 |
City | ESCANABA |
State | MI |
Zip Code | 49829-1292 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295736114 | Al Lagman Romero | Family Medicine | 2500 7th Ave S, Escanaba, MI 49829-1176 | 2005-08-02 |
1790211456 | Janice Beauchamp | Counselor | 2500 7th Ave S, Suite 202, Escanaba, MI 49829-1176 | 2017-05-02 |
1750739272 | Kami Young | Social Worker | 2500 7th Ave S, Suite 100, Escanaba, MI 49829-1176 | 2016-05-25 |
1467800987 | Sasha Sunday Nedeau | Social Worker | 2500 7th Ave S, Suite 100, Escanaba, MI 49829-1176 | 2016-05-25 |
1184099657 | James Ball | Behavioral Analyst | 2500 7th Ave S, Suite 100, Escanaba, MI 49829-1176 | 2015-12-09 |
1952773863 | Adrienne Dunlap | Licensed Practical Nurse | 2500 7th Ave S, Suite 100, Escanaba, MI 49829-1176 | 2015-10-30 |
1710366497 | Nisha Tebear-coolman | Social Worker | 2500 7th Ave S, Suite 100, Escanaba, MI 49829-1176 | 2015-05-27 |
1265825632 | Erin Beaupied | Social Worker | 2500 7th Ave S, Suite 100, Escanaba, MI 49829-1176 | 2015-03-10 |
1568868487 | Donald Pfotenhauer | Dentist | 2500 7th Ave S, Suite 216, Escanaba, MI 49829-1176 | 2014-11-05 |
1053714246 | Patricia Pattan Oneal | Social Worker | 2500 7th Ave S, Suite 100, Escanaba, MI 49829-1176 | 2014-10-01 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770192510 | Haas Hearing Pllc | Audiologist | 423 Ludington Street, Escanaba, MI 49829 | 2020-07-28 |
1104308535 | Lindsay Hope Hall | Occupational Therapist | 2415 5th Ave, Escanaba, MI 49829 | 2018-09-01 |
1962941260 | Amber Joy Quigley | Speech-Language Pathologist | 300 Willow Creek Road, Escanaba, MI 49829 | 2017-02-20 |
1316377799 | Michelle M Holochwost | Physical Therapist | 501 S. Lincoln Road, Escanaba, MI 49829 | 2013-11-20 |
1518304179 | Megan Haas | Audiologist | 423, Suite 1, Escanaba, MI 49829 | 2013-05-22 |
1063768422 | Stacey Lynn Cole | Nurse Practitioner | 3409 Ludington St Ste 104, Escanaba, MI 49829 | 2012-08-03 |
1407177678 | Sarah Jean Nault | Physical Therapist | 501 S. Lincoln Rd, Escanaba, MI 49829 | 2010-06-22 |
1851572960 | James Brian Hull | Occupational Therapist | 2415 Fifth Avenue South, Escanaba, MI 49829 | 2007-11-16 |
1497942841 | Anne M Stein | Nurse Practitioner | 7100 Co. Rd. 426, Escanaba, MI 49829 | 2007-10-01 |
1083813703 | Michael Czerkes | Obstetrics & Gynecology | 3409 Ludington St Ste 204, Escanaba, MI 49829 | 2007-07-12 |
Find all providers in zip 49829 |
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 |
---|---|---|---|---|
1881644029 | James Plowe Inc. | Pharmacy | 1101e Ludington St, Escanaba, MI 49829-3502 | 2006-05-10 |
1932158599 | The Peoples Drug Store, Inc. | Pharmacy | 1208 Ludington St, Escanaba, MI 49829-3539 | 2006-05-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609477389 | Rose Rex LLC | Pharmacy | 2330 S Milford Rd Ste 114, Highland, MI 48357-4982 | 2020-11-08 |
1508466194 | Grand Gratiot Pharmacy, LLC | Pharmacy | 7011 Gratiot Ave Ste 100, Detroit, MI 48207-1973 | 2020-10-31 |
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 |
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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.