Provider Demographics
NPI:1881644029
Name:JAMES PLOWE INC.
Entity Type:Organization
Organization Name:JAMES PLOWE INC.
Other - Org Name:ESCANABA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:O
Authorized Official - Last Name:BERNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:906-786-0131
Mailing Address - Street 1:1101E LUDINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ESCANABA
Mailing Address - State:MI
Mailing Address - Zip Code:49829-3502
Mailing Address - Country:US
Mailing Address - Phone:906-786-0132
Mailing Address - Fax:
Practice Address - Street 1:1101E LUDINGTON ST
Practice Address - Street 2:
Practice Address - City:ESCANABA
Practice Address - State:MI
Practice Address - Zip Code:49829-3502
Practice Address - Country:US
Practice Address - Phone:906-786-0132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010061543336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3095957Medicaid
MI2305779OtherNABP NUMBER
MIBT4230594OtherDEA #
MI0912620001Medicare NSC
MI0P23680Medicare ID - Type UnspecifiedFLU VACCINE PROVIDER NUM.