NPIMap

Organization Active NPI

Riteaid Pharmacy

  • Pharmacist
  • Detroit, MI
National Provider Identifier
1255706149
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302034906 Issued in MI
Legal business name
RITEAID PHARMACY
Practice address
18430 Fenkell St
Detroit, MI 48223-2301
Phone
(313) 837-2340
Fax
(313) 837-0884
NPI assigned
Dec 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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

Authorized official

Name
Mr. Himanshu H Shukla, RPH
Title
Registered Pharmacist
Phone
(734) 233-0823

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 5302034906 MI Primary

Addresses

Primary practice location

18430 Fenkell St
Detroit, MI 48223-2301

Mailing address

18430 Fenkell St
Detroit, MI 48223-2301
Phone (313) 837-2340

Other identifiers 1

IdentifierTypeStateIssuer
5302034906MedicaidMI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1449100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449100800000",
    "number": "1255706149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18430 FENKELL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482232301",
            "telephone_number": "313-837-2340",
            "fax_number": "313-837-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18430 FENKELL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482232301",
            "telephone_number": "313-837-2340",
            "fax_number": "313-837-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RITEAID PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-03",
        "last_updated": "2015-12-03",
        "status": "A",
        "authorized_official_last_name": "SHUKLA",
        "authorized_official_first_name": "HIMANSHU",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "REGISTERED PHARMACIST",
        "authorized_official_telephone_number": "734-233-0823",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302034906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5302034906",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Dec 3, 2015; 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.