Organization Active NPI

Vines Pharmacy LLC

Doing business as Vines Pharmacy

  • Community/Retail Pharmacy
  • Saint Clair Shores, MI
National Provider Identifier
1033935770
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
VINES PHARMACY LLC
Doing business as
Vines Pharmacy
Practice address
31347 Harper Ave
Saint Clair Shores, MI 48082-2453
Phone
(586) 999-8944
Fax
(586) 999-9373
NPI assigned
Nov 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Authorized official

Name
Erjon Bitri, PHARMDNPI 1427514389
Title
Owner/Pic
Phone
(586) 999-8944

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

31347 Harper Ave
Saint Clair Shores, MI 48082-2453

Mailing address

31347 Harper Ave
Saint Clair Shores, MI 48082-2453
Phone (586) 999-8944

Other names 1

  • Vines Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251022000294 MI Part B Supplier - Mass Immunization (Roster Biller Only) 5193213171 Practice locations: Saint CLR Shores, MI

National Provider Directory

National Provider Directory

Locations

31347 Harper Ave
Saint Clair Shores, MI 48082
Phone (586) 999-8944

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1033935770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31347 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480822453",
            "telephone_number": "586-999-8944",
            "fax_number": "586-999-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31347 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480822453",
            "telephone_number": "586-999-8944",
            "fax_number": "586-999-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINES PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "BITRI",
        "authorized_official_first_name": "ERJON",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "586-999-8944",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vines Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.