Divine Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010794 Issued in MI

Legal business name

DIVINE PHARMACY LLC

Practice address

16191 Livernois Avenue
Detroit, MI 48221

Phone

(313) 651-9059

NPI assigned

Jan 20, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Remy OnimoeNPI 1679967038

Title

Owner

Phone

(734) 657-1727

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• DIVINE PHARMACY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Remy Onimoe

  • Pharmacist
  • Southfield, MI
  • NPI 1679967038
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544140800000",
    "number": "1003273202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16191 LIVERNOIS AVENUE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482213724",
            "telephone_number": "313-651-9059",
            "fax_number": "313-659-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16191 LIVERNOIS AVENUE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48221",
            "telephone_number": "313-651-9059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-20",
        "last_updated": "2018-12-07",
        "status": "A",
        "authorized_official_last_name": "ONIMOE",
        "authorized_official_first_name": "REMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-657-1727"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2157415",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003273202",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIVINE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Divine Life Home Care LLC
• Divine Living Homes
• Divine Medical Care
• Divine Medical Center P C
• Divine Mercyy Home Care
• Divine Rehab LLC
• Divine Touch Care Solutions LLC
• Divine Transformations, LLC
• Divine Unity Home Care
• Divine Unity Home Care LLC

• Community/Retail Pharmacy in Detroit, MI
• Providers in Detroit, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.