Radient Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010139 Issued in MI

Legal business name

RADIENT PHARMACY LLC

Practice address

16902 W Warren Ave
Detroit, MI 48228-3505

Phone

(313) 846-7725

NPI assigned

Oct 10, 2013

Organization subpart

No

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

Authorized official

Name

Intsar Ali

Title

President

Phone

(313) 828-1009

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Radient Pharmacy LLC Doing business as

Locations

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382745600000",
    "number": "1114354982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16902 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283505",
            "telephone_number": "313-828-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16902 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283505",
            "telephone_number": "313-846-7725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIENT PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-10",
        "last_updated": "2013-10-26",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "INTSAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-828-1009"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142467",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Radient Pharmacy LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holly Marie Radcliffe, PA-C
• Anneliese Frances Rademacher, MD
• Jennifer Rader, LLMSW
• Crystal Radford, LCSW
• Radiance of Life, LLC
• Ryhm Radjef, MD
• Rachel N Radjewski, LSW
• Thera T Radney, NP-C
• Codrut Silviu Ioan Radoiu, MD
• Nahid Raee

• Community/Retail Pharmacy in Detroit, MI
• Providers in Detroit, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2013; 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.