NPIMap

Organization Active NPI

Bormans Inc

  • Community/Retail Pharmacy
  • Warren, MI
National Provider Identifier
1104841758
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
BORMANS INC
Practice address
14601 E 12 Mile Rd
Warren, MI 48088-3874
Phone
(586) 774-4780
Fax
(586) 774-6842
NPI assigned
Jul 13, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Susan Kijowski
Title
Pharmacy Specialist
Phone
(201) 571-8326

Corporate family (same tax ID) 19

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

National Provider Directory

Tax ID family
Bormans Inc (57 organizations share this tax ID)

Locations

14601 E 12 Mile Rd
Warren, MI 48088
Phone (586) 774-4780

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 5301004539 MI
Community/Retail Pharmacy 3336C0003X Primary

Addresses

NPPES NPI Registry

Primary practice location

14601 E 12 Mile Rd
Warren, MI 48088-3874

Mailing address

14601 E 12 Mile Rd
Warren, MI 48088-3874

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
2798184MedicaidMI
2321951OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

NPPES NPI Registry
  • FARMER JACK PHARMACY Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 11, 2025.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1104841758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14601 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480883874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14601 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480883874",
            "telephone_number": "586-774-4780",
            "fax_number": "586-774-6842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORMANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PHARMACY SPECIALIST",
        "authorized_official_telephone_number": "201-571-8326"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301004539",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2798184",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2321951",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FARMER JACK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

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