Individual provider Active NPI

Firdaus Ruby Rosario, PHARMD

  • Pharmacist
  • Northville, MI
National Provider Identifier
1215570098
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302411921 Issued in MI
Practice address
20401 Haggerty Rd
Northville, MI 48167-1999
Phone
(248) 349-2707
NPI assigned
Oct 23, 2019
Last updated
Oct 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302411921 MI Primary

Addresses

Primary practice location

20401 Haggerty Rd
Northville, MI 48167-1999

Mailing address

129 S Edgeworth Ave
Royal Oak, MI 48067-3933

Other practice location 1

45001 Ford Rd
Canton, MI 48187-2907
Phone (734) 844-2710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
5302411921MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1215570098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 S EDGEWORTH AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20401 HAGGERTY RD",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671999",
            "telephone_number": "248-349-2707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45001 Ford Rd",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MI",
            "postal_code": "481872907",
            "country_code": "US",
            "telephone_number": "734-844-2710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSARIO",
        "first_name": "FIRDAUS",
        "middle_name": "RUBY",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302411921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; 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.