NPIMap

Organization Active NPI

Bormans Inc

  • Community/Retail Pharmacy
  • Walled Lake, MI
National Provider Identifier
1194740753
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
Practice address
730 N Pontiac TRL
Walled Lake, MI 48390-3408
Phone
(248) 926-2902
Fax
(248) 926-2916
NPI assigned
Jul 13, 2006
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 5301006368 MI
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

730 N Pontiac TRL
Walled Lake, MI 48390-3408

Mailing address

730 N Pontiac TRL
Walled Lake, MI 48390-3408

Other identifiers 2

IdentifierTypeStateIssuer
2355344OtherOTHER ID NUMBER-COMMERCIAL NUMBER
3208371MedicaidMI

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

Locations

730 N Pontiac Trl
Walled Lake, MI 48390
Phone (248) 926-2902

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": "1194740753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N PONTIAC TRL",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N PONTIAC TRL",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903408",
            "telephone_number": "248-926-2902",
            "fax_number": "248-926-2916"
        }
    ],
    "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": "5301006368",
            "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": "2355344",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3208371",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FARMER JACK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walled Lake, 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.