NPIMap

Organization Active NPI

Pioneer Medical Pharmacy LLC

  • Community/Retail Pharmacy
  • Taylor, MI
National Provider Identifier
1043584725
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301009756 Issued in MI
Legal business name
PIONEER MEDICAL PHARMACY LLC
Practice address
12701 Telegraph Rd
Taylor, MI 48180-6847
Phone
(734) 250-8858
Fax
(734) 250-8901
NPI assigned
Feb 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Authorized official

Name
Chandra Chittiprolu
Title
President
Phone
(248) 635-8827

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 5301009756 MI Primary
Compounding Pharmacy 3336C0004X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

12701 Telegraph Rd
Taylor, MI 48180-6847

Mailing address

12701 Telegraph Rd
Taylor, MI 48180-6847
Phone (734) 250-8858

Other identifiers 1

IdentifierTypeStateIssuer
2376398OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • PIONEER MEDICAL PHARMACY Doing business as

National Provider Directory

National Provider Directory

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": "1330387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1043584725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12701 TELEGRAPH RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481806847",
            "telephone_number": "734-250-8858",
            "fax_number": "734-250-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12701 TELEGRAPH RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481806847",
            "telephone_number": "734-250-8858",
            "fax_number": "734-250-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER MEDICAL PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-28",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "CHITTIPROLU",
        "authorized_official_first_name": "CHANDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-635-8827"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009756",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2376398",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PIONEER MEDICAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Taylor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.

Verify at the official NPI Registry.