| NPI | 1124060652 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-06-11 |
| Last Updated | 2011-09-27 |
| Authorized Official | Glenda King PRESIDENT AND OWNER Phone: 2697492301 |
| Mailing Address | Po Box 537 Olivet, MI 49076-0537 United States 📍 View Map |
| Primary Practice Address | 102 Washington St Olivet, MI 49076-9462 United States Phone: (269) 749-2301 | Fax: (269) 749-2301 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | MI | 1737040 | — |
| Other (non-Medicare) | — | 2318978 | NCPDP Provider Identification Number |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 333600000X – Pharmacy | — | — |
| Yes | 3336C0003X – Pharmacy, Community/Retail Pharmacy | MI | 5301000875 |
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About NPI 1124060652
Olivet Pharmacy Inc is an organization registered in the CMS NPPES NPI Registry with NPI number 1124060652. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Olivet, MI. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-06-11. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1124060652?
NPI 1124060652 belongs to Olivet Pharmacy Inc, a Pharmacy, Community/Retail Pharmacy in Olivet, MI. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1124060652 active?
The current status of NPI 1124060652 in the NPPES registry is Active. The record was last updated on 2011-09-27.
What specialty is NPI 1124060652?
NPI 1124060652 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1124060652?
You can verify NPI 1124060652 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1124060652?
The primary practice address on file for NPI 1124060652 is 102 Washington St, Olivet, MI 49076-9462. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1124060652 issued?
NPI 1124060652 was first issued (enumerated) on 2006-06-11. The NPPES record was last updated on 2011-09-27.
Practice Location Map
Olivet Pharmacy Inc is located at 102 Washington St, Olivet, MI. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Olivet Pharmacy Inc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1124060652. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy | 5301000875 | MI |