Active NPI
Luc Lucaj
- Pharmacist
- Shelby Township, MI
National Provider Identifier
1003542044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302414395
- Practice address
- 15121 24 Mile Rd
Shelby Township, MI 48315-2109 - Phone
- (586) 677-4015
- NPI assigned
- Jul 30, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302414395 | MI | Primary |
Addresses
Primary practice location
15121 24 Mile Rd
Shelby Township, MI 48315-2109
Mailing address
55940 Romeo Plank Rd
Macomb, MI 48042-1622
Phone (586) 453-7002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302414395 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659139200000",
"number": "1003542044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55940 ROMEO PLANK RD",
"city": "MACOMB",
"state": "MI",
"postal_code": "480421622",
"telephone_number": "586-453-7002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15121 24 MILE RD",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483152109",
"telephone_number": "586-677-4015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAJ",
"first_name": "LUC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-30",
"last_updated": "2022-07-30",
"certification_date": "2022-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302414395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelby Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.