Individual provider Active NPI

Aram J Makkinejad

  • Pharmacist
  • Deckerville, MI
National Provider Identifier
1104440395
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302411994 Issued in MI
Practice address
2046 Black River St Ste 2
Deckerville, MI 48427-9448
Phone
(810) 376-8070
Fax
(810) 376-8071
NPI assigned
Jun 3, 2020
Last updated
Oct 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302411994 MI Primary

Addresses

Primary practice location

2046 Black River St Ste 2
Deckerville, MI 48427-9448

Mailing address

281 Hartland Dr
Troy, MI 48083-5011
Phone (248) 525-1757

Other practice location 1

39 Kristian St
Sandusky, MI 48471-1035
Phone (810) 648-4668

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
5302411994MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Selad Corporation PastSince Oct 13, 2024 Accepting new patients
Rite Aid of Michigan Inc PastSince Jun 1, 2020 Accepting new patients
Rite Aid of Michigan Inc PastSince Jun 1, 2020 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1104440395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 HARTLAND DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835011",
            "telephone_number": "248-525-1757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 BLACK RIVER ST STE 2",
            "city": "DECKERVILLE",
            "state": "MI",
            "postal_code": "484279448",
            "telephone_number": "810-376-8070",
            "fax_number": "810-376-8071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39 Kristian St",
            "address_purpose": "LOCATION",
            "city": "Sandusky",
            "state": "MI",
            "postal_code": "484711035",
            "country_code": "US",
            "telephone_number": "810-648-4668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAKKINEJAD",
        "first_name": "ARAM",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302411994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deckerville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.