Active NPI
Gbogbara Inc
Doing business as King Pharmacy
- Community/Retail Pharmacy
- Roseville, MI
National Provider Identifier
1063860484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 5301010945
- Legal business name
- GBOGBARA INC
- Doing business as
- King Pharmacy
- Practice address
- 28350 Gratiot Ave
Roseville, MI 48066 - Phone
- (586) 218-8181
- Fax
- (586) 884-3488
- NPI assigned
- May 26, 2016
- Last updated
- Dec 9, 2020
- Organization subpart
- Yes
- Parent organization
- GBOGBARA INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Lenyie Ngbogbara
- Title
- President
- Phone
- (313) 319-4444
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 5301010945 | MI | Primary |
Addresses
Primary practice location
28350 Gratiot Ave
Roseville, MI 48066
Mailing address
28350 Gratiot Ave
Roseville, MI 48066
Phone (586) 218-8181
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2160295 | Other | PK |
Other names 1
- King Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Gbogbara Inc
- Part of
- Gbogbara Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Community/Retail Pharmacy
- Detroit, MI
- NPI 1982715447
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464220800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1607472000000",
"number": "1063860484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28350 GRATIOT AVE",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "48066",
"telephone_number": "586-218-8181",
"fax_number": "586-884-3488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28350 GRATIOT AVE",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "48066",
"telephone_number": "586-218-8181",
"fax_number": "586-884-3488"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GBOGBARA INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "GBOGBARA INC",
"enumeration_date": "2016-05-26",
"last_updated": "2020-12-09",
"certification_date": "2020-12-09",
"status": "A",
"authorized_official_last_name": "NGBOGBARA",
"authorized_official_first_name": "LENYIE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "313-319-4444",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MI",
"license": "5301010945",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2160295",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "King Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Roseville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.