NPIMap

Organization Active NPI

Bormans Inc

Doing business as Farmer Jack Pharmacy

  • Community/Retail Pharmacy
  • South Lyon, MI
National Provider Identifier
1184649741
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
BORMANS INC
Doing business as
Farmer Jack Pharmacy
Practice address
22385 Pontiac TRL
South Lyon, MI 48178-1646
Phone
(248) 446-3534
Fax
(248) 446-3519
NPI assigned
Jul 13, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Susan Kijowski
Title
Pharmacy Specialist
Phone
(201) 571-8326

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 5301007095 MI
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

22385 Pontiac TRL
South Lyon, MI 48178-1646

Mailing address

22385 Pontiac TRL
South Lyon, MI 48178-1646

Other identifiers 2

IdentifierTypeStateIssuer
2360624OtherOTHER ID NUMBER-COMMERCIAL NUMBER
4156313MedicaidMI

Other names 1

  • FARMER JACK PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bormans Inc57 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1184649741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22385 PONTIAC TRL",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22385 PONTIAC TRL",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781646",
            "telephone_number": "248-446-3534",
            "fax_number": "248-446-3519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORMANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "KIJOWSKI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PHARMACY SPECIALIST",
        "authorized_official_telephone_number": "201-571-8326"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301007095",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2360624",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4156313",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FARMER JACK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Lyon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.