Bonne Sante Compounding Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010444 Issued in MI

Legal business name

BONNE SANTE COMPOUNDING PHARMACY LLC

Doing business as

Bonne Sante Pharmacy

Practice address

36700 Woodward Ave
Suite 105
Bloomfield Hills, MI 48304-0926

Phone

(249) 792-2920

Fax

(248) 792-2865

NPI assigned

Jun 24, 2014

Organization subpart

No

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

Authorized official

Name

Kshama Jayasuriya

Title

R.PH

Phone

(248) 792-2920

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Bonne Sante Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415836800000",
    "number": "1215342639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36700 WOODWARD AVE",
            "address_2": "SUITE 105",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483040926",
            "telephone_number": "249-792-2920",
            "fax_number": "248-792-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36700 WOODWARD AVE",
            "address_2": "SUITE 105",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483040926",
            "telephone_number": "249-792-2920",
            "fax_number": "248-792-2865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONNE SANTE COMPOUNDING PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-11-13",
        "status": "A",
        "authorized_official_last_name": "JAYASURIYA",
        "authorized_official_first_name": "KSHAMA",
        "authorized_official_title_or_position": "R.PH",
        "authorized_official_telephone_number": "248-792-2920"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010444",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2146643",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bonne Sante Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christian Bogner, M.D.
• Paul J Bohdiewicz, MD
• Kristen Lee Boike, MS, LPC
• Boloms Transport Services, LLC
• Camille Bolton, LLPC
• Kalsey Boots
• Lauren Borg, RD
• Edward Anthony Borio, DDS
• George Edward Bork, DDS
• Kenneth Astrat Borovich, DDS

• Community/Retail Pharmacy in Bloomfield Hills, MI
• Providers in Bloomfield Hills, 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 Nov 13, 2014; 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.