Pontiac Trail Pharmacy Inc
Community/Retail Pharmacy
620 N. Pontiac Trail, Walled Lake
Michigan, 48390
248-669-2776 248-669-2835
Pontiac Trail Pharmacy Inc is a Community/Retail Pharmacy in Walled Lake, Michigan. It is located at 620 N. Pontiac Trail, Walled Lake and it's customer support contact number is 248-669-2776. The authorized person of Pontiac Trail Pharmacy Inc is Mr. Carl Robert Hendricks, R.PH who is Owner/r.ph. of the pharmacy and his contact number is 248-669-2776. Active license number of Pontiac Trail Pharmacy Inc is 5301004197 for Community/Retail Pharmacy in Michigan. Pontiac Trail Pharmacy Inc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Pontiac Trail Pharmacy Inc is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Pharmacy Details:
Pontiac Trail Pharmacy Inc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Pontiac Trail Pharmacy Inc |
| Type: | Community/Retail Pharmacy |
| Location: | 620 N. Pontiac Trail, Walled Lake,
Michigan, 48390 |
| Phone: | 248-669-2776 |
| Fax: | 248-669-2835 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Mr. Carl Robert Hendricks |
| Credentials: | R.PH |
| Position: | Owner/r.ph. |
| Contact Number: | 248-669-2776 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1902914377 |
| NPI Enumeration Date: | 27 Aug, 2006 |
| NPI Last Update On: | 01 Aug, 2017 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Pontiac Trail Pharmacy Inc are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | 5301004197 | Michigan | Primary | |
| Long Term Care Pharmacy | | | Secondary | |
| Health Service | | | Secondary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 2338689 | Medicaid | Michigan | |
| 1665835 | Medicaid | Michigan | |
| 1649484 | Medicaid | Michigan | |
| 2338689 | Other | | Other Id Number |
Medicare Enrollment:
Pontiac Trail Pharmacy Inc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 9638235880 | O20090313000026 | Pontiac Trail Pharmacy Inc | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
| 9638235880 | O20100930015121 | Pontiac Trail Pharmacy Inc | DME SUPPLIER - PHARMACY |
Products Available:
Pontiac Trail Pharmacy Inc has following products available for sale under medicare.
| Products: |
|---|
| • Blood Glucose Monitors & Supplies: Non-mail Order | • Canes & Crutches |
| • Nebulizer Equipment & Supplies | • Orthoses: Off-the-shelf |
| • Ostomy Supplies | • Surgical Dressings |
| • Urological Supplies | • Walkers |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 43155 W. Nine Mile Rd.,
Novi, Michigan |
| Zip: | 48376-8026 |
| Phone Number: | -- |
Patients can reach Pontiac Trail Pharmacy Inc at
620 N. Pontiac Trail, Walled Lake, Michigan or can
call on customer care at 248-669-2776.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.