NPIMap

Organization Active NPI

St. Clair Shore Pharmacy Mi LLC

Doing business as Shoppers Pharmacy

  • Community/Retail Pharmacy
  • Saint Clair Shores, MI
National Provider Identifier
1104260066
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5315059314 Issued in MI
Legal business name
ST. CLAIR SHORE PHARMACY MI LLC
Doing business as
Shoppers Pharmacy
Practice address
25014 Little Mack Ave
Saint Clair Shores, MI 48080
Phone
(586) 359-6517
Fax
(586) 359-6523
NPI assigned
Apr 23, 2013
Last updated
May 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Authorized official

Name
Hema Patel
Title
Owner
Phone
(813) 304-2221

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 5315059314 MI Primary
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

25014 Little Mack Ave
Saint Clair Shores, MI 48080

Mailing address

25014 Little Mack Ave
Saint Clair Shores, MI 48080
Phone (586) 359-6517

Other identifiers 1

IdentifierTypeStateIssuer
2140011OtherPK

Other names 1

  • Shoppers Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
RX Care of Mi3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1104260066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25014 LITTLE MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "48080",
            "telephone_number": "586-359-6517",
            "fax_number": "586-359-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25014 LITTLE MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "48080",
            "telephone_number": "586-359-6517",
            "fax_number": "586-359-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CLAIR SHORE PHARMACY MI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-23",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "HEMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-304-2221"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5315059314",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140011",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoppers Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shoppers Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.