O2 Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301011378 Issued in MI

Legal business name

O2 PHARMACY, LLC

Doing business as

o2 Pharmacy

Practice address

39765 Grand River Ave
Novi, MI 48375

Phone

(248) 987-2024

Fax

(248) 987-6998

NPI assigned

Apr 30, 2018

Last updated

Apr 15, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carlos Chinchilla

Title

Owner

Phone

(888) 224-3081

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• o2 Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1114415668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39765 GRAND RIVER AVE",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752107",
            "telephone_number": "248-987-2024",
            "fax_number": "248-987-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39765 GRAND RIVER AVE",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48375",
            "telephone_number": "248-987-2024",
            "fax_number": "248-987-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "O2 PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-30",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "CHINCHILLA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-224-3081"
    },
    "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": "5301011378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2177506",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "o2 Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Novi, MI
• Providers in Novi, 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 Apr 15, 2020; 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.