Northville Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009947 Issued in MI

Legal business name

NORTHVILLE PHARMACY LLC

Practice address

116 W Main St
Northville, MI 48167-1521

Phone

(248) 924-3752

Fax

(248) 924-3760

NPI assigned

Nov 3, 2012

Organization subpart

No

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

Authorized official

Name

Lina MalladNPI 1255923694

Title

Owner/Pharmacist

Phone

(313) 522-7519

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Northville Pharmacy Doing business as

Locations

Practitioners 1

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

• Lina Mallad

  • Pharmacist
  • Redford, MI
  • NPI 1255923694
  NPD Authorized official

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

{
    "created_epoch": "1351900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384128000000",
    "number": "1134473713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 W MAIN ST",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671521",
            "telephone_number": "248-924-3752",
            "fax_number": "248-924-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W MAIN ST",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671521",
            "telephone_number": "248-924-3752",
            "fax_number": "248-924-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHVILLE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-03",
        "last_updated": "2013-11-11",
        "status": "A",
        "authorized_official_last_name": "MALLAD",
        "authorized_official_first_name": "LINA",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "313-522-7519"
    },
    "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": "5301009947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2377352",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134473713",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Northville, MI
• Providers in Northville, 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 Nov 11, 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.