Individual provider Active NPI

Pankajkumar Somabhai Patel

  • Pharmacist
  • Southfield, MI
National Provider Identifier
1063536910
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302035156 Issued in MI
Practice address
28949 Northwestern Hwy
Rite Aid Pharmacy
Southfield, MI 48034-1805
Phone
(732) 829-8085
NPI assigned
Mar 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302035156 MI Primary

Addresses

Primary practice location

28949 Northwestern Hwy
Rite Aid Pharmacy
Southfield, MI 48034-1805

Mailing address

28949 Northwestern Hwy
Rite Aid Pharmacy
Southfield, MI 48034-1805
Phone (732) 829-8085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5302035156MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063536910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28949 NORTHWESTERN HWY",
            "address_2": "RITE AID PHARMACY",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341805",
            "telephone_number": "732-829-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28949 NORTHWESTERN HWY",
            "address_2": "RITE AID PHARMACY",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341805",
            "telephone_number": "732-829-8085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PANKAJKUMAR",
        "middle_name": "SOMABHAI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302035156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.