WOODWARD DETROIT CVS, L.L.C. (NPI# 1770685018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770685018 |
| Entity Type | Organization |
| Organization Name | WOODWARD DETROIT CVS, L.L.C. |
| Other Organization Name | CVS PHARMACY #08114 |
| Practice Address |
15300 Eureka Rd Southgate MI 48195-3261 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 7342839500 |
| Practice Fax Number | 7342832248 |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2014-06-25 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR) |
| 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 | 5301-005608 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 2749930 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2348882 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #08114 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861796112 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 3590 Plainfield Ave Ne, Grand Rapids, MI 49525-2719 | 2010-12-30 |
| 1790002921 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 5449 Jackson Rd, Ann Arbor, MI 48103 | 2010-04-28 |
| 1033374319 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 7488 Village Center Dr., Whitmore Lake, MI 48189 | 2008-07-25 |
| 1922273424 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 57090 Ten Mile Rd, South Lyon, MI 48178-9718 | 2008-04-25 |
| 1922271162 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 15521 West Seven Mile Road, Detroit, MI 48235 | 2008-04-09 |
| 1326216797 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 44300 Five Mile Rd., Northville Township, MI 48167 | 2008-02-19 |
| 1538352976 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 51000 Romeo Plank Rd, Macomb, MI 48042-4128 | 2007-08-20 |
| 1144429952 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 5756 Clarkston Rd, Clarkston, MI 48348-4706 | 2007-07-12 |
| 1811195993 | Woodward Detroit Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 50980 North Ave, Macomb, MI 48042-4626 | 2007-07-10 |
| 1356481352 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 5408 Whittaker Road, Ypsilanti Township, MI 48197 | 2007-02-07 |
| Street Address |
15300 EUREKA RD |
| City | SOUTHGATE |
| State | MI |
| Zip Code | 48195-3261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285250985 | Kouakou Konan | Pharmacist | 15300 Eureka Rd, Southgate, MI 48195-3261 | 2020-06-18 |
| 1386275162 | Erica King | Pharmacist | 15300 Eureka Rd, Southgate, MI 48195-3261 | 2020-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206656 | Destiny D Harris | Social Worker | 14799, Southgate, MI 48195 | 2020-05-13 |
| 1285102368 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 16256 Fort St, Southgate, MI 48195 | 2018-11-07 |
| 1003382979 | Saran Charisse Watts | Case Manager/Care Coordinator | 31101 Allen Rd, Building 5, Southgate, MI 48195 | 2018-10-18 |
| 1255824025 | Kiesta Janell Lindsey | Social Worker | 13101 Allen Rd Bldg 4-f, Southgate, MI 48195 | 2018-06-07 |
| 1417473224 | Suzette Michele Watson | Nurse Practitioner | 14319 Dix-toledo, Southgate, MI 48195 | 2017-08-15 |
| 1275069486 | Liza Du Plessis | Student in an Organized Health Care Education/Training Program | 13111 Allen Road, Southgate, MI 48195 | 2017-05-08 |
| 1497290456 | Beaumont Health | Clinic/Center | 15777 Northline, Southgate, MI 48195 | 2016-12-30 |
| 1184172876 | Felicia Wilson | Licensed Practical Nurse | 15771 Wildemere, Southgate, MI 48195 | 2016-09-12 |
| 1225487978 | Stacey Petrick-strickland | Technician, Other | 12189 Agnes, Southgate, MI 48195 | 2016-06-03 |
| 1205298486 | Ashley Francis | Hearing Instrument Specialist | 18800 Eureka Rd., Southgate, MICHIGAN 48195 | 2016-03-25 |
| Find all providers in zip 48195 | ||||
| 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 |
|---|---|---|---|---|
| 1508212366 | Prime Care Pharmacy LLC | Pharmacy | 3 Heritage Dr # 3, Southgate, MI 48195-3000 | 2016-05-11 |
| 1265843320 | Downriver Family Pharmacy LLC | Pharmacy | 14156 Eureka Rd, Southgate, MI 48195-2055 | 2014-05-12 |
| 1306137864 | Derossi S Pharmacy LLC | Pharmacy | 15348 Fort St, Southgate, MI 48195-1304 | 2011-05-02 |
| 1235144841 | Queens Pharmacy | Pharmacy | 15007 Eureka Rd, Southgate, MI 48195-2609 | 2006-07-30 |
| 1477578037 | Bormans Inc | Pharmacy | 13777 Eureka Rd, Southgate, MI 48195-1352 | 2006-07-13 |
| 1356992317 | Monas Pharmacy LLC | Pharmacy | 15031 Eureka Rd, Southgate, MI 48195-2609 | 2019-09-21 |
| 1437692779 | Md Royal Pharmacy Inc | Pharmacy | 12866 Fort St, Southgate, MI 48195-1060 | 2016-11-18 |
| 1407211253 | Family Health Pharmacy LLC | Pharmacy | 15450 Northline Rd, Ste 102, Southgate, MI 48195-2398 | 2015-12-21 |
| 1891969911 | East River Associates LLC | Pharmacy | 13101 Allen Road, Suite 511, Southgate, MI 48195 | 2008-04-18 |
| 1669657367 | Oakwood Healthcare Inc | Pharmacy | 15777 Northline Rd, Ste 100a, Southgate, MI 48195-2385 | 2008-01-02 |
| Find all providers in SOUTHGATE | ||||
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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.