Abe S Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301011084 Issued in MI

Legal business name

ABE S PHARMACY LLC

Doing business as

Abe's Drug Store

Practice address

13760 E 12 Mile Rd Ste B
Warren, MI 48088-3751

Phone

(586) 362-8404

Fax

(586) 251-0322

NPI assigned

Jan 17, 2017

Last updated

Jun 22, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hussein Mansour, PHARMDNPI 1629426861

Title

Pic

Phone

(313) 686-8666

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Abe's Drug Store Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hussein Mansour

  • Pharmacist
  • Allen Park, MI
  • NPI 1629426861
  Authorized official Same address or phone
• Youssef Bazzi, RPH

  • Pharmacist
  • Eastpointe, MI
  • NPI 1235853680
  NPD (past)
• Adam Rettig, PHARMD

  • Pharmacist
  • Clinton Township, MI
  • NPI 1386504025
  NPD (past)

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624320000000",
    "number": "1013453950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13760 E 12 MILE RD STE B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480883751",
            "telephone_number": "586-362-8404",
            "fax_number": "586-251-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13760 E 12 MILE RD STE B",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480883751",
            "telephone_number": "586-362-8404",
            "fax_number": "586-251-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABE S PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-17",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A",
        "authorized_official_last_name": "MANSOUR",
        "authorized_official_first_name": "HUSSEIN",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "313-686-8666",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301011084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013453950",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2167138",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abe's Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eiman Abdallah, MD
• Sarah Ann Abdelrahman
• Maya Abdoullahi, PA-C
• Faris Abdulaziz
• Victor Antoun Abdullatif, DO
• Abe S Pharmacy LLC
• Abe's Drug Store LLC
• Abelardo G Contreras MD PC
• Hafsa Abid, DPM
• Abiding Love I LLC

• 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 Jun 22, 2021; 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.