Pickwick Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PICKWICK PHARMACY LLC

Practice address

13720 E 12 Mile Rd
Warren, MI 48088-3751

Phone

(586) 250-2509

Fax

(586) 250-0392

NPI assigned

Jul 9, 2025

Organization subpart

No

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

Authorized official

Name

Abbas Mansour

Title

Owner

Phone

(586) 250-2509

Specialties & licenses 1

Addresses

Other names 1

• ADS - Warren Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770595200000",
    "number": "1003706060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13700 E 12 MILE RD # 104",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480883751",
            "telephone_number": "586-250-2509",
            "fax_number": "586-250-0392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13720 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480883751",
            "telephone_number": "586-250-2509",
            "fax_number": "586-250-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICKWICK PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-09",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "ABBAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-250-2509"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADS - Warren",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Timothy Phillips, RPH, CIP
• William Tremaine Phillips
• Physical Cognitive Network, Inc.
• Physiotherapy Associates Inc
• Pick Me Up Now, LLC
• Matthew J. Pieper, COTA/L
• Piero a. Simone, M.D., P.C.
• Mary Pierpoint
• Shariya Ninique Pierre
• Guy Pierret, M.D.

• Community/Retail Pharmacy in Warren, MI
• Providers in Warren, 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 Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.