Pioneer Pharmacy 1 Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010808 Issued in MI

Legal business name

PIONEER PHARMACY 1 INC

Practice address

39575 W 10 Mile Rd
Ste 204
Novi, MI 48375-2949

Phone

(248) 957-8456

Fax

(248) 536-2074

NPI assigned

Jan 8, 2016

Organization subpart

No

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

Authorized official

Name

Ali Moukdad

Title

Owner/Pic

Phone

(248) 957-8456

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Pioneer Pharmacy 1 INC Doing business as

Locations

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

{
    "created_epoch": "1452211200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470096000000",
    "number": "1134585011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39575 W 10 MILE RD",
            "address_2": "STE 204",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752949",
            "telephone_number": "248-957-8456",
            "fax_number": "248-536-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39575 W 10 MILE RD",
            "address_2": "STE 204",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752949",
            "telephone_number": "248-957-8456",
            "fax_number": "248-536-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIONEER PHARMACY 1 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-08",
        "last_updated": "2016-08-02",
        "status": "A",
        "authorized_official_last_name": "MOUKDAD",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "248-957-8456"
    },
    "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": "5301010808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2157936",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pioneer Pharmacy 1 INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Riley Pigott
• Sarah Piippo
• Mary Piland
• Eustace Pilgram
• Srilakshmi Pinnamaraju, MD
• Yolanda D Piper
• Cicily Juanita Pippens
• Jeffrey Scott Pirtle, PA-C
• Francesca Piscitelli
• Sharickia Pitts

• 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 Aug 2, 2016; 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.