PINE KNOB PHARMACY #4 (NPI# 1629256169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629256169 |
| Entity Type | Organization |
| Organization Name | PINE KNOB PHARMACY #4 |
| Practice Address |
5710 Bella Rosa Blvd Clarkston MI 48348-4773 |
| Practice Telephone | 2486200296 |
| Mailing Telephone | 2486200296 |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2008-02-06 |
| Authorized Official Name | DR. ANTHONY JAY PLAS (MANAGER) |
| Authorized Official Telephone | 2486200296 |
| Authorized Official Credential | PHARM.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Street Address |
5710 BELLA ROSA BLVD |
| City | CLARKSTON |
| State | MI |
| Zip Code | 48348-4773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255449625 | Pine Knob Pharmacy 4 Inc | Pharmacy | 5710 Bella Rosa Blvd, Clarkston, MI 48348-4773 | 2006-08-27 |
| 1699000174 | Vikas R Soni | Physical Therapist | 5710 Bella Rosa Blvd, Suite # 300, Clarkston, MI 48348-4773 | 2009-10-16 |
| 1154410975 | Daniel Mccoskey | Pharmacist | 5710 Bella Rosa Blvd, Clarkston, MI 48348-4773 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548100 | Grey Street Counseling and Wellness Center, LLC | Counselor | 314 Moonlite Court, Clarkston, MI 48348 | 2020-11-06 |
| 1134787906 | Claudia Maryann Beauvais | Peer Specialist | 4533 Sedona Dr, Clarkston, MI 48348 | 2019-06-05 |
| 1669965299 | Wellbridge of Clarkston, LLC | Skilled Nursing Facility | 5655 Clarkston Road, Independence Township, MI 48348 | 2018-06-08 |
| 1164794251 | Kong C. Choi | Family Medicine | 8324 Caribou Trl., Clarkston, MI 48348 | 2012-02-03 |
| 1447587753 | Carrie Ann Schlicht | Occupational Therapist | 7508 Mecad Boulevard, Suite A, Clarkston, MI 48348 | 2009-11-06 |
| 1740424290 | Nedra Gean Downing | General Practice | 5715 Bella Rose Blvd., Ste 100, Clarkston, MI 48348 | 2009-04-28 |
| 1467600528 | Brian Davidson Dds PC | Dentist | 5720 Clarkston Road, Clarkston, MI 48348 | 2008-09-03 |
| 1962624957 | Keri Sue Hickmott | Social Worker | 9340 Dixie Highway, Clarkston, MI 48348 | 2007-05-02 |
| 1720209273 | Linda Carole Gualdoni | Physical Therapist | 7508 M.e. Cad Blvd., Suite A, Clarkston, MI 48348 | 2007-05-01 |
| 1396964466 | David William Regiani | Dentist | 10435 Ortonville Road, Suite B, Clarkston, MI 48348 | 2007-04-25 |
| Find all providers in zip 48348 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629572599 | Befitting You, LLC | Durable Medical Equipment & Medical Supplies | 7650 Dixie Hwy Ste 130, Clarkston, MI 48346-2078 | 2018-03-23 |
| 1225433717 | Henry Hunt | Durable Medical Equipment & Medical Supplies | 1612 Rimview Dr, Clarkston, WA 99403-3041 | 2014-10-27 |
| 1639593528 | Irb Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 5701 Bow Pointe Dr Ste 105, Clarkston, MI 48346-3199 | 2014-02-12 |
| 1598044208 | Scooter Chair Repair Georgia, LLC | Durable Medical Equipment & Medical Supplies | 3519 Church St, Unit D, Clarkston, GA 30021-1723 | 2011-08-11 |
| 1396977203 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 306 5th St, Clarkston, WA 99403-1860 | 2009-08-12 |
| 1952545758 | Staniszewski Optometry Pllc | Durable Medical Equipment & Medical Supplies | 7111 Dixie Hwy # 152, Clarkston, MI 48346-2077 | 2009-04-23 |
| 1295918571 | William H Reuther | Durable Medical Equipment & Medical Supplies | 7478 Gateway Park Dr Ste B, Clarkston, MI 48346-2574 | 2007-12-10 |
| 1104029743 | Premier Braces | Durable Medical Equipment & Medical Supplies | 1366 Bridge St, Clarkston, WA 99403-2332 | 2007-06-11 |
| 1205906013 | Rite Aid of Michigan Inc | Durable Medical Equipment & Medical Supplies | 5751 Clarkston Road, Clarkston, MI 48348-4707 | 2006-11-09 |
| 1891804357 | Perry Drug Stores Inc and Subsidiaries | Durable Medical Equipment & Medical Supplies | 5789 Ortonville Road, Clarkston, MI 48346-2959 | 2006-08-29 |
| Find all providers in CLARKSTON | ||||
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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.