MEDICARE: PIONEER FAMILY PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	5301007107	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23-60698	OTHER		NABP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154302073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIONEER FAMILY PHARMACY INC

Provider Business Mailing Address
First Line	:	PO BOX 38
Second Line	:
City	:	SAINT HELEN
State	:	MI
Zip	:	48656-0038
Country	:	US
Telephone Number	:	989-389-7252
Fax Number	:	989-389-7232

Provider Business Practice Location Address
First Line	:	2100 N SAINT HELEN RD
Second Line	:
City	:	SAINT HELEN
State	:	MI
Zip	:	48656-9209
Country	:	US
Telephone Number	:	989-389-7252
Fax Number	:	989-389-7232

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD K BRAIDWOOD
Credential	:	RPH
Telephone Number	:	989-389-7277

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	03/23/2017

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Directions to “PIONEER FAMILY PHARMACY INC ” Practice Location

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