{"npi":"1831289735","type":"NPI-2","status":"active","name":{"display":"Charlevoix Commons Apothecary, Ltd","other":[],"organization_name":"CHARLEVOIX COMMONS APOTHECARY, LTD","authorised_official":"Lacey Gilde"},"specialty":{"primary_taxonomy":"3336C0003X","primary_taxonomy_description":"Community/Retail Pharmacy","slug":"community-retail-pharmacy","schema_org_specialty":null,"all":[{"code":"332B00000X","description":"Durable Medical Equipment & Medical Supplies","primary":false,"state":null,"license":null},{"code":"3336C0003X","description":"Community/Retail Pharmacy","primary":true,"state":"MI","license":"5301000205"}]},"addresses":[{"purpose":"LOCATION","street_1":"301 BRIDGE ST","city":"CHARLEVOIX","state":"MI","postal_code":"497201414","country_code":"US","phone":"2315472424","fax":"2315470670"},{"purpose":"MAILING","street_1":"301 BRIDGE ST","city":"CHARLEVOIX","state":"MI","postal_code":"497201414","country_code":"US","phone":"2315472424","fax":"2315470670"}],"license":{"state":"MI","number":"5301000205"},"identifiers":[{"type_code":"01","label":"Other","value":"2313156","state":"MI","issuer":"NCPDP"},{"type_code":"05","label":"Medicaid","value":"2313156","state":"MI","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20100930040416","type_code":"30-A5","type_desc":"DME SUPPLIER - PHARMACY","state":"MI","pac_id":"7719007277"},{"enrlmt_id":"O20140725001362","type_code":"12-73","type_desc":"PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY)","state":"MI","pac_id":"7719007277"},{"enrlmt_id":"O20200714003107","type_code":"12-69","type_desc":"PART B SUPPLIER - INDEPENDENT CLINICAL LABORATORY","state":"MI","pac_id":"7719007277"}]},"enumeration_date":"2006-10-13","last_updated":"2025-11-17","_meta":{"source":"NPPES","snapshot_date":"2025-11-17","doc_url":"https://findmynpi.com/api"}}