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NPI Code Detail

MEDICARE: NORTHGATE PHARMACY

MEDICARE: NORTHGATE PHARMACY
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
1332B00000XDurable Medical Equipment & Medical Supplies5301007690MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1540C210260OTHERMIBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528019072
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHGATE PHARMACY
Provider Business Mailing Address
First Line : 721 N VAN DYKE RD
Second Line :
City : BAD AXE
State : MI
Zip : 48413-9188
Country : US
Telephone Number : 989-269-8061
Fax Number : 989-269-9189
Provider Business Practice Location Address
First Line : 721 N VAN DYKE RD
Second Line :
City : BAD AXE
State : MI
Zip : 48413-9188
Country : US
Telephone Number : 989-269-8061
Fax Number : 989-269-2094
Authorized Official
Title or Position : OWNER
Name : MR. JON VOLK
Credential : RPH
Telephone Number : 989-269-8061
Provider Enumeration Date : 05/12/2006
Last Update Date : 03/30/2009

Similar Medicare Providers

1780689026 — NORTHGATE PHARMACY INC.
Practice Location Address:
721 N VAN DYKE RD
BAD AXE, MI
48413-9188
Practice Phone: 989-269-8061
Practice Fax:
1821168691 — NORTHGATE PHARMACY INC.
Practice Location Address:
721 N VAN DYKE RD
BAD AXE, MI
48413-9188
Practice Phone: 989-269-8061
Practice Fax: 989-269-9189
1518007954 — MR. JONATHAN JAMES VOLK RPH
Practice Location Address:
721 N VAN DYKE RD
BAD AXE, MI
48413-9188
Practice Phone: 989-269-8061
Practice Fax: 989-269-9189
1245912468 — MRS. TARA LYNN DOHNING
Practice Location Address:
721 N VAN DYKE RD # 7
BAD AXE, MI
48413-9188
Practice Phone: 989-269-9229
Practice Fax:
1285418327 — MS. JESSICA A BROWN
Practice Location Address:
721 N VAN DYKE RD
BAD AXE, MI
48413-9188
Practice Phone: 989-269-9229
Practice Fax:
1457135584 — BRIANNA WISENBAUGH
Practice Location Address:
721 N VAN DYKE RD
BAD AXE, MI
48413-9188
Practice Phone: 989-269-9229
Practice Fax:

Directions to “NORTHGATE PHARMACY ” Practice Location

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