Clinton Medical Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301008045 Issued in MI

Legal business name

CLINTON MEDICAL PHARMACY

Doing business as

mgt investments enterprises llc

Practice address

43475 Dalcoma Dr
Suite 110
Clinton Township, MI 48038-3591

Phone

(586) 228-7601

Fax

(586) 228-7605

NPI assigned

May 8, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer Smith

Title

Ceo

Phone

(586) 228-7601

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• mgt investments enterprises llc Doing business as

Locations

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245289362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43475 DALCOMA DR",
            "address_2": "SUITE 110",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383591",
            "telephone_number": "586-228-7601",
            "fax_number": "586-228-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43475 DALCOMA DR",
            "address_2": "SUITE 110",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383591",
            "telephone_number": "586-228-7601",
            "fax_number": "586-228-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON MEDICAL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "586-228-7601"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301008045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B7957R",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "mgt investments enterprises llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Myrsha Clemons, LLMSW
• Clifford L Weldon M D P L C
• Clinton Care Pharmacy LLC
• Clinton Diagnostic, LLC
• Clinton Fitness Inc (Powerhouse Gym Macomb)
• Clinton Pain and Anesthesia PLC
• Clinton Partners, LLC (Surgery Center of Clinton Township)
• Clinton RX
• Clinton Township Chiropractic PC
• Clinton Township Dialysis LLC (Clinton Township Dialysis)

• Community/Retail Pharmacy in Clinton Township, MI
• Providers in Clinton Township, 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 Aug 22, 2020; 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.