Provider Demographics
NPI:1487621892
Name:PHARMA CARE INC
Entity type:Organization
Organization Name:PHARMA CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACISTS
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:MILES
Authorized Official - Last Name:DORHOUT
Authorized Official - Suffix:SR
Authorized Official - Credentials:RPH PRESIDENT
Authorized Official - Phone:810-659-5608
Mailing Address - Street 1:PO BOX 480
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433
Mailing Address - Country:US
Mailing Address - Phone:810-659-5608
Mailing Address - Fax:810-659-6789
Practice Address - Street 1:209 S CHERRY ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433
Practice Address - Country:US
Practice Address - Phone:810-659-5608
Practice Address - Fax:810-659-6789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23D1009655291U00000X
MIC333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2311227OtherNCPDP
MI1802498Medicaid
MI540B50560OtherBLUE CROSS BLUE SHIELD
MI540B50560OtherBLUE CROSS BLUE SHIELD
MI23D1009655Medicare ID - Type UnspecifiedCLIA WAIVER
0412710001Medicare UPIN