Blossom Care Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010768 Issued in MI

Legal business name

BLOSSOM CARE PHARMACY LLC

Practice address

5250 Auto Club Dr Ste 160
Dearborn, MI 48126-2619

Phone

(313) 436-5513

Fax

(313) 436-5405

NPI assigned

Dec 7, 2015

Organization subpart

No

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

Authorized official

Name

Imane Alzaroui, RPH

Title

Owner, Pic, Ao

Phone

(313) 377-0793

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• BLOSSOM CARE PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484870400000",
    "number": "1134594898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 AUTO CLUB DR STE 160",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262619",
            "telephone_number": "313-436-5513",
            "fax_number": "313-436-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 AUTO CLUB DR STE 160",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262619",
            "telephone_number": "313-436-5513",
            "fax_number": "313-436-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOSSOM CARE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-07",
        "last_updated": "2017-01-20",
        "status": "A",
        "authorized_official_last_name": "ALZAROUI",
        "authorized_official_first_name": "IMANE",
        "authorized_official_title_or_position": "OWNER, PIC, AO",
        "authorized_official_telephone_number": "313-377-0793",
        "authorized_official_credential": "RPH"
    },
    "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": "5301010768",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2381363",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155809",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLOSSOM CARE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Dearborn, MI
• Providers in Dearborn, 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 Jan 20, 2017; 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.