Eastern Michigan Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301008958 Issued in MI

Legal business name

EASTERN MICHIGAN PHARMACY INC

Doing business as

Eastern MIchigan Pharmacy

Practice address

1159 E Michigan Ave
Ypsilanti, MI 48198-5807

Phone

(734) 485-9900

Fax

(734) 485-9300

NPI assigned

Oct 22, 2008

Last updated

Nov 3, 2009By 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

Sami Dabaja, RPH

Title

Owner

Phone

(734) 485-9900

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Eastern MIchigan Pharmacy Doing business as

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257206400000",
    "number": "1053563940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1159 E MICHIGAN AVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985807",
            "telephone_number": "734-485-9900",
            "fax_number": "734-485-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1159 E MICHIGAN AVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985807",
            "telephone_number": "734-485-9900",
            "fax_number": "734-485-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN MICHIGAN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-22",
        "last_updated": "2009-11-03",
        "status": "A",
        "authorized_official_last_name": "DABAJA",
        "authorized_official_first_name": "SAMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-485-9900",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301008958",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2371831",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastern MIchigan Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Max Dyksterhouse, M.D.
• Safiya Francesca Dzotsi
• Ellen Gray East, MD
• Kalee Easter, AU.D.
• Lauren Noelle Easterbrook, CRNA
• Eastern Michigan University (Autism Collaborative Center)
• Eastern Michigan University
• Eastern Michigan University (University Health Services)
• Eastern Michigan University (Snow Health Services Pharmacy)
• Eastern Michigan University (Counseling and Psychological Services)

• Community/Retail Pharmacy in Ypsilanti, MI
• Providers in Ypsilanti, 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 Nov 3, 2009; 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.