Pontiac Trail Pharmacy Inc
NPI 1902914377 · Community/Retail Pharmacy · Walled Lake, MI
Enrolled with Medicare as Part B Supplier - Mass Immunization (roster Biller Only) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Pontiac Trail Pharmacy Inc is a Community/Retail Pharmacy organization in Walled Lake, MI (NPI 1902914377).
Provider details
- NPI number
- 1902914377
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Carl Hendricks, Owner/R.ph.(248) 669-2776
Specialties & taxonomies
Suppliers
- Long Term Care Pharmacy3336L0003X
Suppliers
- Health Service Clinic/Center261QH0100X
Ambulatory Health Care Facilities
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
19 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
16 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Administration of Influenza Virus VaccineG0008 | 16 | $31 |
Typical Medicare-allowed amounts for these services range $31–$31 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Pontiac Trail Medical Pharmacy
Registry dates
- Enumerated
- 2006-08-27
- Last updated
- 2017-08-01
Frequently asked questions
- What is Pontiac Trail Pharmacy Inc's NPI number?
- Pontiac Trail Pharmacy Inc's National Provider Identifier (NPI) is 1902914377, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pontiac Trail Pharmacy Inc?
- Pontiac Trail Pharmacy Inc is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Pontiac Trail Pharmacy Inc located?
- Pontiac Trail Pharmacy Inc's practice location on file with NPPES is 620 N. Pontiac Trail, Walled Lake, MI 48390.
- What is Pontiac Trail Pharmacy Inc's phone number?
- The practice phone number listed in the NPPES registry for Pontiac Trail Pharmacy Inc is (248) 669-2776.
- Does Pontiac Trail Pharmacy Inc accept Medicare?
- Pontiac Trail Pharmacy Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Pontiac Trail Pharmacy Inc?
- The authorized official listed on Pontiac Trail Pharmacy Inc's NPPES record is Carl Hendricks, Owner/R.ph.. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pontiac Trail Pharmacy Inc's NPI active?
- Yes — Pontiac Trail Pharmacy Inc's NPI (1902914377) is active in the NPPES registry as of the last update on 2017-08-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.