MB Wellness Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MB WELLNESS PHARMACY

Practice address

2041 Fort St
Lincoln Park, MI 48146-2402

Phone

(734) 239-2597

NPI assigned

Feb 10, 2025

Organization subpart

No

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

Authorized official

Name

Mahdi Bazzoun, PHARMACISTNPI 1497439897

Title

Owner

Phone

(734) 239-2597

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mahdi Moustapha Bazzoun, RPH

  • Pharmacist
  • Howell, MI
  • NPI 1497439897
  NPD Authorized official

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1104631050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462402",
            "telephone_number": "734-239-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MB WELLNESS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "BAZZOUN",
        "authorized_official_first_name": "MAHDI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-239-2597",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Lincoln Park, MI
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.