Provider Demographics
NPI:1699725283
Name:PINNY PHARMACY INC
Entity type:Organization
Organization Name:PINNY PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SPIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-876-8899
Mailing Address - Street 1:704 S MABLE ST
Mailing Address - Street 2:PO BOX 777
Mailing Address - City:PINCONNING
Mailing Address - State:MI
Mailing Address - Zip Code:48650-9348
Mailing Address - Country:US
Mailing Address - Phone:989-879-7705
Mailing Address - Fax:989-879-6950
Practice Address - Street 1:704 S MABLE ST
Practice Address - Street 2:
Practice Address - City:PINCONNING
Practice Address - State:MI
Practice Address - Zip Code:48650-9348
Practice Address - Country:US
Practice Address - Phone:989-879-7705
Practice Address - Fax:989-879-6950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010072763336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2361842Medicaid