WILDERNS DRUG STORE


Address: 123 Lansing Road, Potterville, MI 48876
Phone: 5176457680

WILDERNS DRUG STORE (NPI# 1881669745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1881669745
Entity Type Organization
Organization Name WILDERNS DRUG STORE
Practice Address 123 Lansing Road
Potterville
MI 48876
Mailing Address 123 Lansing Road
Wilderns Drug Store #2
Potterville
MI 48876
Practice Telephone 5176457680
Practice Fax Number 5176457698
Mailing Telephone 5176457680
Mailing Fax Number 5176457698
Enumeration Date 2006-02-22
Last Update Date 2020-08-22
Authorized Official Name MR. JEFFREY ALAN WILDERN (PRESIDENT)
Authorized Official Telephone 5176457680
Authorized Official Credential RPH
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 333600000X Pharmacy 5301004387 MI Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
MI 2340444 05
MI BCBSM 2340444 01

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1568435873 Wilderns Drug Store Durable Medical Equipment & Medical Supplies 201 S Cochran Ave, Charlotte, MI 48813-1550 2006-02-08

Office Location

Street Address 123 LANSING ROAD
City POTTERVILLE
State MI
Zip Code 48876

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932419652 Joann Mildred Schafer Social Worker 710 W. Lawrence, Charlotte, MI 48876 2010-10-15
1518000587 Michael J. Line Physician Assistant 133 E. Lansing Rd., Potterville, MI 48876 2007-02-15
1487684221 Thomas A. Sainz D.o., P.c Family Medicine 133 E Lansing Rd, Potterville, MI 48876 2006-07-04
1679963250 Monica Fuentes Licensed Practical Nurse 310 N Church St, Potterville, MI 48876-5123 2015-02-03
1164631131 Kristin Mau Dentist 400 S Nelson St, Potterville, MI 48876-8774 2007-05-22
1437172491 Mid Michigan General Dentistry Dentist 400 S Nelson St, Suite B, Potterville, MI 48876-8774 2006-07-25
1407073554 Kristine Kay Peterson Physical Therapy Assistant 602 Laurens Way, Potterville, MI 48876-8798 2007-04-19
1760542997 Janet Marie Archer Physical Therapy Assistant 7325 Hartel Rd, Potterville, MI 48876-8803 2006-12-11
1508999467 Shawn Desiree Floyd I Licensed Practical Nurse 212 Adams Ct, Potterville, MI 48876-9501 2007-03-13
1326325382 Melissa M Ridge Counselor 219 Constitution Cir, Potterville, MI 48876-9521 2011-11-04
Find all providers in zip 48876

Taxonomy Information

Taxonomy Code 333600000X
Grouping Suppliers
Classification Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1558961763 Dustyn Daniel Thoney Pharmacy 530 Harding Ave, Iron River, MI 49935-2265 2020-10-27
1497355697 Katherine Jane Cybulski Pharmacy 1310 Waukazoo St, Hastings, MI 49058-9559 2020-10-27
1043836042 Hanan Pharmacy LLC Pharmacy 4600 E 14 Mile Road, Suite 2, Warren, MI 48092-1057 2020-06-25
1770104192 Hazelwood Pharmacy LLC Pharmacy 624 E 9 Mile Rd Ste C, Hazel Park, MI 48030-1842 2020-04-27
1457980609 Berkley Pharmacy LLC Pharmacy 28577 Schoenherr Road, Warren, MI 48088 2020-04-08
1669012316 Warriors Pharmacy, Inc. Pharmacy 5265 Anthony Wayne Dr, Detroit, MI 48202-3947 2020-01-10
1457996662 Sunrise Pharmacy, LLC Pharmacy 989 University Dr Ste 104, Pontiac, MI 48342-1885 2019-11-12
1447894019 Nova Pharmacy Pharmacy 15140 Levan Rd, Suite 40, Livonia, MI 48154 2019-11-06
1912541673 Wayne Pharma Pharmacy 974 Ford Ave, Wyandotte, MI 48192 2019-11-05
1639720667 Grand Haven Pharmacy LLC Pharmacy 930 John R Rd Ste Pharmacy, Troy, MI 48083-4316 2019-09-20
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Competitor

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City POTTERVILLE
Zip Code 48876

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Dataset Information

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.

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