NPIMap

Organization Active NPI

Mi Care Pharmacy LLC

  • Community/Retail Pharmacy
  • Mount Clemens, MI
National Provider Identifier
1003295569
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301010681 Issued in MI
Legal business name
MI CARE PHARMACY LLC
Practice address
33 Church St
Mount Clemens, MI 48043-2331
Phone
(586) 447-8777
Fax
(586) 447-8902
NPI assigned
May 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Authorized official

Name
Renu Pathak
Title
Owner,Ao
Phone
(443) 783-5539

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301010681 MI Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

33 Church St
Mount Clemens, MI 48043-2331

Mailing address

33 Church St
Mount Clemens, MI 48043-2331
Phone (586) 447-8777

Other identifiers 1

IdentifierTypeStateIssuer
2152207OtherPK

Other names 1

  • Mi Care Pharmacy II Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mi Care Pharmacy II2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

33 Church St
Mount Clemens, MI 48043
Phone (586) 447-8777

NPI Registry JSON

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

{
    "created_epoch": "1432857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437955200000",
    "number": "1003295569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 CHURCH ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432331",
            "telephone_number": "586-447-8777",
            "fax_number": "586-447-8902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 CHURCH ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432331",
            "telephone_number": "586-447-8777",
            "fax_number": "586-447-8902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MI CARE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-29",
        "last_updated": "2015-07-27",
        "status": "A",
        "authorized_official_last_name": "PATHAK",
        "authorized_official_first_name": "RENU",
        "authorized_official_title_or_position": "OWNER,AO",
        "authorized_official_telephone_number": "443-783-5539"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010681",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2152207",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mi Care Pharmacy II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Clemens, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; 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.