Organization Active NPI

Hanan Pharmacy LLC

  • Community/Retail Pharmacy
  • Warren, MI
National Provider Identifier
1043836042
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
HANAN PHARMACY LLC
Practice address
4600 E 14 Mile Road
Suite 2
Warren, MI 48092-1057
Phone
(586) 999-5951
Fax
(586) 554-7701
NPI assigned
Jun 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Authorized official

Name
Mrs. Hanan Pharmacy
Title
Owner
Phone
(586) 999-5951

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

4600 E 14 Mile Road
Suite 2
Warren, MI 48092-1057

Mailing address

4600 E 14 Mile Rd Ste 2
Warren, MI 48092-4369

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220126002782 MI Part B Supplier - Pharmacy 9133511009 Practice locations: Warren, MI

National Provider Directory

National Provider Directory

Locations

4600 E 14 Mile Rd
Ste 2
Warren, MI 48092
Phone (586) 274-9030

NPI Registry JSON

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1043836042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 E 14 MILE RD STE 2",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 E 14 MILE ROAD",
            "address_2": "SUITE 2",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480921057",
            "telephone_number": "586-999-5951",
            "fax_number": "586-554-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANAN PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-25",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "PHARMACY",
        "authorized_official_first_name": "HANAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-999-5951",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.