Active NPI
Lina Mallad
- Pharmacist
- Redford, MI
National Provider Identifier
1255923694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302031849
- Practice address
- 24224 Joy Rd Ste 103
Redford, MI 48239-1215 - Phone
- (313) 532-4000
- Fax
- (313) 532-4241
- NPI assigned
- Feb 8, 2021
- Last updated
- Feb 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302031849 | MI | Primary |
Addresses
Primary practice location
24224 Joy Rd Ste 103
Redford, MI 48239-1215
Mailing address
PO Box 87542
Canton, MI 48187-0542
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302031849 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ofp Inc | Current | Accepting new patients | |
| Northville Pharmacy LLC | Current | Accepting new patients | |
| Ofp Inc | Past | Accepting new patients |
Locations
24224 Joy Rd
Ste 103
Redford, MI 48239
Phone (313) 532-4000
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Northville Pharmacy
- Community/Retail Pharmacy
- Northville, MI
- NPI 1134473713
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612742400000",
"number": "1255923694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 87542",
"city": "CANTON",
"state": "MI",
"postal_code": "481870542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24224 JOY RD STE 103",
"city": "REDFORD",
"state": "MI",
"postal_code": "482391215",
"telephone_number": "313-532-4000",
"fax_number": "313-532-4241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLAD",
"first_name": "LINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-08",
"last_updated": "2021-02-08",
"certification_date": "2021-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302031849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.