Provider Demographics
NPI:1912127010
Name:PHARMA CARE INC
Entity Type:Organization
Organization Name:PHARMA CARE INC
Other - Org Name:TRI COUNTY MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:MILES
Authorized Official - Last Name:DORHOUT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:810-659-5608
Mailing Address - Street 1:209 S CHERRY ST
Mailing Address - Street 2:ATTN TCMC
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-2020
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:ATTN TCMC
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-2020
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:2007-04-30
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0412711001332BN1400X
MI53010019663336C0004X, 3336H0001X, 3336L0003X
MI332B00000X, 332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2311227OtherNCPDP
MI1802498Medicaid
MI540B50560OtherBLUE CROSS BLUE SHIELD
MI1943960Medicaid
MI01002520OtherHEALTHPLUS OF MICHIGAN
MI540B50560OtherBLUE CROSS BLUE SHIELD