Organization Active NPI

Samaritran Pharmacy PC

Doing business as Samaritran Pharmacy

  • Community/Retail Pharmacy
  • Detroit, MI
National Provider Identifier
1225209265
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301008807 Issued in MI
Legal business name
SAMARITRAN PHARMACY PC
Doing business as
Samaritran Pharmacy
Practice address
5575 Conner St
1A Pavilion
Detroit, MI 48213-6400
Phone
(313) 922-8920
Fax
(313) 922-8923
NPI assigned
Mar 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Authorized official

Name
Abbas Baydoun
Title
Pic
Phone
(313) 922-8920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301008807 MI Primary

Addresses

Primary practice location

5575 Conner St
1A Pavilion
Detroit, MI 48213-6400

Mailing address

5575 Conner St
1A Pavilion
Detroit, MI 48213-6400
Phone (313) 922-8920

Other identifiers 1

IdentifierTypeStateIssuer
2043633OtherPK

Other names 1

  • SAMARITRAN PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

5575 Conner St
Ste 1A
Detroit, MI 48213
Phone (313) 922-8920

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415145600000",
    "number": "1225209265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 CONNER ST",
            "address_2": "1A PAVILION",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482136400",
            "telephone_number": "313-922-8920",
            "fax_number": "313-922-8923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 CONNER ST",
            "address_2": "1A PAVILION",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482136400",
            "telephone_number": "313-922-8920",
            "fax_number": "313-922-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITRAN PHARMACY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2014-11-05",
        "status": "A",
        "authorized_official_last_name": "BAYDOUN",
        "authorized_official_first_name": "ABBAS",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "313-922-8920"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301008807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2043633",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAMARITRAN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.