Organization · Type 2 NPI

Ascension Borgess Hospital

Community/Retail Pharmacy · Portage, MI

NPI number 1174677611 Active

Practice location

7901 Angling Rd
Portage, MI 49024-0714

Fax (269) 324-8458

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	5301006331 (MI)

Community/Retail Pharmacy: 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 …

38 other providers at this address

Other community/retail pharmacy providers in Portage

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NPI record

NPI: 1174677611
Entity type: Organization (Type 2)
Issued: Jan 22, 2007
Last updated: Nov 26, 2025
Status: Active

Other names

<unavail>
Ascension RX 1311 · doing business as
Beacon Portage Outpatient Pharmacy · doing business as

Authorized official

Jeffrey Peter Costello
CFO
(574) 647-3460

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1174677611

Ascension Borgess Hospital's National Provider Identifier is 1174677611, issued on Jan 22, 2007. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Portage, MI. The record was last updated on Nov 26, 2025.