Fort St RX Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301011416 Issued in MI

Legal business name

FORT ST RX PHARMACY LLC

Practice address

2017 Fort St
Lincoln Park, MI 48146-2402

Phone

(313) 702-0066

NPI assigned

Jul 16, 2018

Organization subpart

No

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

Authorized official

Name

Sobhi Mike Neme

Title

Owner

Phone

(313) 702-0066

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531699200000",
    "number": "1073099701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462402",
            "telephone_number": "313-702-0066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462402",
            "telephone_number": "313-702-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT ST RX PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-16",
        "last_updated": "2018-07-16",
        "status": "A",
        "authorized_official_last_name": "NEME",
        "authorized_official_first_name": "SOBHI",
        "authorized_official_middle_name": "MIKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-702-0066"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301011416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Lincoln Park, MI
• Providers in Lincoln Park, 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 Jul 16, 2018; 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.