Active NPI
Mohammed Mustafizur Rahman
- Pharmacist
- Grand Ledge, MI
National Provider Identifier
1003648387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302416288
- Practice address
- 812 E Saginaw Hwy
Grand Ledge, MI 48837-8410 - Phone
- (517) 627-1240
- NPI assigned
- Aug 15, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 | 5302416288 | MI | Primary |
Addresses
Primary practice location
812 E Saginaw Hwy
Grand Ledge, MI 48837-8410
Mailing address
11443 Meadowbrook Dr
Warren, MI 48093-6555
Phone (313) 409-2192
Other names 1
- Mohammed Mustafizur Rahman
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 |
|---|---|---|---|
| 5302416288 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Mediaid Pharmacy | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
812 E Saginaw Hwy
Grand Ledge, MI 48837
Phone (517) 627-1240
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Hamtramck, MI
- NPI 1548136195
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723680000000",
"number": "1003648387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11443 MEADOWBROOK DR",
"city": "WARREN",
"state": "MI",
"postal_code": "480936555",
"telephone_number": "313-409-2192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 E SAGINAW HWY",
"city": "GRAND LEDGE",
"state": "MI",
"postal_code": "488378410",
"telephone_number": "517-627-1240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAHMAN",
"first_name": "MOHAMMED",
"middle_name": "MUSTAFIZUR",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-08-15",
"last_updated": "2024-08-15",
"certification_date": "2024-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302416288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MOHAMMED",
"last_name": "RAHMAN",
"middle_name": "MUSTAFIZUR",
"credential": "PHARMD",
"code": "2",
"type": "Professional Name"
}
]
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- Powerback Rehabilitation LLC
- Rellim Incorporated (Millers Pharmacy and Gift Shop)
- Kara Richards, LPC
- Nicole Richards
- Jacob Daniel Richardson
- Richs Residential and Home Care Options
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.