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PORTAGE PHARMACY INC. NPI 1992735666


NPI Information

NPI: 1992735666
Provider Name: PORTAGE PHARMACY, INC.

Doing Business As: PORTAGE PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 23D2241473

Address:
7966 LOVERS LN
PORTAGE, MI
ZIP 49002
Phone: (269) 327-0033
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PORTAGE PHARMACY, INC. is a community/retail pharmacy pharmacy in Portage, MI. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. PORTAGE PHARMACY, INC. NPI is 1992735666. The provider is registered as an organization entity type.
The provider Is Doing Business As Portage Pharmacy.

The provider's business location address is:

7966 LOVERS LN
PORTAGE, MI
ZIP 49002-446
Phone: (269) 327-0033
Fax: (269) 327-2709

The provider's authorized official is Lawrence Curtis .
The authorized official title is Vice President and has the following contact phone number (269) 327-0033.

The CLIA number assigned to this NPI record is 23D2241473 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/5/2006 and was last updated on 7/19/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0003XPharmacyCommunity/Retail Pharmacy1994-43WISCONSINNo
23336C0003XPharmacyCommunity/Retail PharmacyNRP.022791200-03OHIONo
33336C0003XPharmacyCommunity/Retail Pharmacy035724NEW YORKNo
43336C0003XPharmacyCommunity/Retail PharmacyNP000798PENNSYLVANIANo
53336C0004XPharmacyCompounding Pharmacy64002337AINDIANANo
63336C0003XPharmacyCommunity/Retail Pharmacy054.017842ILLINOISYes
7333600000XPharmacy5301002930MICHIGANNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12040070OTHERPK
22527217MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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