Woodhaven Medical Center Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

5301006509 Issued in MI

Legal business name

WOODHAVEN MEDICAL CENTER PHARMACY INC

Practice address

4700 Greenfield Rd
Dearborn, MI 48126-4124

Phone

(313) 581-8200

Fax

(313) 581-7141

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Ali Nasser, RPH

Title

Owner

Phone

(313) 581-8200

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• WOODHAVEN MEDICAL CENTER PHARMACY Doing business as

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436832000000",
    "number": "1174610877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 GREENFIELD RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264124",
            "telephone_number": "313-581-8200",
            "fax_number": "313-581-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 GREENFIELD RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264124",
            "telephone_number": "313-581-8200",
            "fax_number": "313-581-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODHAVEN MEDICAL CENTER PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2015-07-14",
        "status": "A",
        "authorized_official_last_name": "NASSER",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-581-8200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301006509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "873324521",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM DME",
            "identifier": "540H216930",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2356550",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WOODHAVEN MEDICAL CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• George J. Wonsul, R.PH.
• Jean Jimin Woo
• Jessie Nicole Wood
• Darnell Lloyd Woodall Jr., CHW
• Tanisha Sawhawnn Woodard
• Martisha Marissa Woodruff
• Katherine E Woods, DO
• Kyiatirah Aunyeah-Cmone Woods
• Zhane Woods
• Desmond Deangelo Woodson Jr.

• Pharmacy in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; 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.