BEAVERTON FAMILY PHARMACY LLC
NPI 1053133975
Pharmacy - Long Term Care Pharmacy in Beaverton, MI

Q: What is Beaverton Family Pharmacy LLC's NPI number?

The NPI number for Beaverton Family Pharmacy LLC is 1053133975. It was assigned to this organization in the NPPES registry on October 30, 2024. The provider is doing business as Beaverton Family Pharmacy LTC.

Q: What is Beaverton Family Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

Active since October 30, 2024CLIA 23D2351184 · Waiver

3210 W LANG RD, BEAVERTON, MI 48612(989) 339-9008 Get Directions Write a Review

NPPES record last updated: October 30, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Beaverton Family Pharmacy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEAVERTON FAMILY PHARMACY LLC (NPI 1053133975), doing business as Beaverton Family Pharmacy Ltc, is a healthcare organization registered as a long term care pharmacy in Beaverton, Michigan and active in the NPI registry since October 2024. The organization holds a CLIA Waiver certificate valid through September 21, 2028 and lists John Gross, Owner, as its authorized official.

NPPES Registry Identity

NPI1053133975

Entity TypeOrganization

Primary Taxonomy3336L0003X

Legal Business NameBEAVERTON FAMILY PHARMACY LLC

Location Address3210 W LANG RDBeaverton, MI 48612-8102

Mailing Address11271 Harrison AveFarwell, MI 48622-9439

Phone(989) 339-9008

Organization SubpartNo

Authorized OfficialJohn GrossOwner · (989) 339-9008

Enumeration DateOctober 30, 2024

NPPES CertifiedOctober 30, 2024

✔ NPI 1053133975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers

Taxonomy Code3336L0003X

Definition

A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

3210 W LANG RD, Beaverton, MI 48612

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Other Names 1

Doing Business AsBeaverton Family Pharmacy Ltc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2351184

Beaverton Family Pharmacy LLC · Beaverton, MI

Active · expires Sep 21, 2028

CLIA Number23D2351184

Laboratory TypePharmacy

Certificate Effective DateSeptember 22, 2026

Certificate Expiration DateSeptember 21, 2028

Laboratory DirectorJoshua T. Gross

Laboratory Phone(989) 435-6048

Laboratory LocationBeaverton Family Pharmacy LLC3210 W Lang Road, Beaverton, MI 48612

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BEAVERTON FAMILY PHARMACY LLC

Pharmacy (Community/Retail Pharmacy)

3210 W LANG RD
BEAVERTON, MI 48612

Gladwin County (989) 339-9008

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beaverton Family Pharmacy LLC's NPI number?

The NPI number for Beaverton Family Pharmacy LLC is 1053133975. It was assigned to this organization in the NPPES registry on October 30, 2024. The provider is doing business as Beaverton Family Pharmacy LTC.

Where is Beaverton Family Pharmacy LLC located?

Beaverton Family Pharmacy LLC is located at 3210 W Lang Rd, Beaverton, MI 48612. The listed phone number is (989) 339-9008.

What is Beaverton Family Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

Does Beaverton Family Pharmacy LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2351184) is associated with this NPI, valid through September 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Beaverton Family Pharmacy LLC accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Blue Cross Blue Shield of North Dakota, Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Alabama and 10 other insurers list Beaverton Family Pharmacy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Beaverton Family Pharmacy LLC was last updated on October 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.