NPIMap

Organization Active NPI

Riverside Prof. Drug Inc.

  • Durable Medical Equipment & Medical Supplies
  • Trenton, MI
National Provider Identifier
1265602494
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
5301003409 Issued in MI
Legal business name
RIVERSIDE PROF. DRUG INC.
Practice address
2801 W Jefferson Ave
Trenton, MI 48183-2901
Phone
(734) 676-3784
Fax
(734) 676-3793
NPI assigned
Mar 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Authorized official

Name
Mr. Keith Haddix Jr., R.PH.
Title
Pharmacist/Owner
Phone
(734) 676-3784

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 5301003409 MI Primary

Addresses

Primary practice location

2801 W Jefferson Ave
Trenton, MI 48183-2901

Mailing address

2801 W Jefferson Ave
Trenton, MI 48183-2901
Phone (734) 676-3784

National Provider Directory

National Provider Directory
Tax ID family
Riverside Prof Drug Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1265602494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 W JEFFERSON AVE",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481832901",
            "telephone_number": "734-676-3784",
            "fax_number": "734-676-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 W JEFFERSON AVE",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481832901",
            "telephone_number": "734-676-3784",
            "fax_number": "734-676-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PROF. DRUG INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "HADDIX",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "734-676-3784",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5301003409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.