Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pontiac Trail Pharmacy Inc

Organization Health Service Clinic/Center · NPI 1902914377

Pontiac Trail Pharmacy Inc is a Health Service Clinic/Center in Walled Lake, Michigan. Licensed in Michigan. Registered with an NPI since 2006.

Licensed in
MI
In the registry since
2006
Specialties on file
4
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

620 N Pontiac Trl
Walled Lake, MI 48390
Phone: (248) 669-2776
Fax: (248) 669-2835
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X · Licence 5301004197 (MI)
Health Service Clinic/Center Taxonomy 261QH0100X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X
Long Term Care Pharmacy Taxonomy 3336L0003X

Record details

NPI number1902914377
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carl Hendricks — Owner/R.Ph. · (248) 669-2776
Other names Pontiac Trail Medical Pharmacy
NPI enumeratedAugust 27, 2006
Last updated in NPPESAugust 1, 2017
Mailing address43155 W. Nine Mile Rd., Novi, MI 48376-8026