Bogdan Yavorenko, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302038894 Issued in MI

Practice address

10915 Belleville Rd
Van Buren TWP, MI 48111-1386

Phone

(734) 697-4000

NPI assigned

Jan 30, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Woodward Detroit CVS, L.L.C.

  • Pharmacy
  • Van Buren TWP, MI
  • NPI 1437261369
  NPD

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1093346942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10915 BELLEVILLE RD",
            "city": "VAN BUREN TWP",
            "state": "MI",
            "postal_code": "481111386",
            "telephone_number": "734-697-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10915 BELLEVILLE RD",
            "city": "VAN BUREN TWP",
            "state": "MI",
            "postal_code": "481111386",
            "telephone_number": "734-697-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAVORENKO",
        "first_name": "BOGDAN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302038894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dakota Russell Waring
• William Beaumont Hospital
• Angela Michelle Williams, LLPC
• Lakisha Williams
• Woodward Detroit CVS, L.L.C.
• Ypsilanti Rehabilitation Services, Inc.

• All providers in Van Buren TWP, MI
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.

Verify at the official NPI Registry.