Active NPI
Talal Maisari
- Pharmacist
- Allen Park, MI
National Provider Identifier
1124449202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5301010269
- Practice address
- 14737 Champaign Rd
Allen Park, MI 48101-1616 - Phone
- (313) 383-8300
- NPI assigned
- Dec 17, 2013
- Reactivated
- Jul 1, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5301010269 | MI | Primary |
Addresses
Primary practice location
14737 Champaign Rd
Allen Park, MI 48101-1616
Mailing address
14737 Champaign Rd
Allen Park, MI 48101-1616
Phone (313) 383-8300
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5301010269 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DMZ Pharmacy LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Dearborn, MI
- NPI 1467879759
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625097600000",
"number": "1124449202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14737 CHAMPAIGN RD",
"city": "ALLEN PARK",
"state": "MI",
"postal_code": "481011616",
"telephone_number": "313-383-8300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14737 CHAMPAIGN RD",
"city": "ALLEN PARK",
"state": "MI",
"postal_code": "481011616",
"telephone_number": "313-383-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAISARI",
"first_name": "TALAL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-12-17",
"last_updated": "2021-07-01",
"certification_date": "2021-07-01",
"deactivation_date": "2017-10-23",
"reactivation_date": "2021-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5301010269",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allen Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.