Organization Active NPI

Atlas Meds Pharmacy Inc

Doing business as Atlas Meds Pharmacy

  • Community/Retail Pharmacy
  • Lansing, MI
National Provider Identifier
1205245586
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301010592 Issued in MI
Legal business name
ATLAS MEDS PHARMACY INC
Doing business as
Atlas Meds Pharmacy
Practice address
4801 S Martin Luther King Jr Blvd
Lansing, MI 48910-5111
Phone
(517) 580-0991
Fax
(517) 580-0992
NPI assigned
Aug 12, 2014
Last updated
Feb 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Authorized official

Name
Dalia Elgohary, RPHNPI 1477036655
Title
President
Phone
(517) 580-0991

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 5301010592 MI Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

4801 S Martin Luther King Jr Blvd
Lansing, MI 48910-5111

Mailing address

4801 S Martin Luther King Jr Blvd
Lansing, MI 48910-5111
Phone (517) 580-0991

Other identifiers 1

IdentifierTypeStateIssuer
2147647OtherPK

Other names 1

  • Atlas Meds Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201118001292 MI Part B Supplier - Mass Immunization (Roster Biller Only) 4880005131 Practice locations: Lansing, MI
O20220607002126 MI Part B Supplier - Independent Clinical Laboratory 4880005131 Practice locations: Lansing, MI

National Provider Directory

National Provider Directory

Locations

4801 S Martin Luther King Jr Blvd
Lansing, MI 48910
Phone (517) 580-0991

5016 S Martin Luther King Jr Blvd
Lansing, MI 48910
Phone (517) 580-0991

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1407801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1205245586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 S MARTIN LUTHER KING JR BLVD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489105111",
            "telephone_number": "517-580-0991",
            "fax_number": "517-580-0992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 S MARTIN LUTHER KING JR BLVD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489105111",
            "telephone_number": "517-580-0991",
            "fax_number": "517-580-0992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLAS MEDS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-12",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "ELGOHARY",
        "authorized_official_first_name": "DALIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-580-0991",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010592",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147647",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlas Meds Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Atlas Meds Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.