Active NPI
Brian John Peltz, RPH
- Pharmacist
- Dearborn, MI
National Provider Identifier
1275690133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302025437
- Practice address
- 4700 Schaefer Rd
Suite 340
Dearborn, MI 48126-3655 - Phone
- (313) 827-5565
- Fax
- (313) 429-5165
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302025437 | MI | Primary |
| Pharmacist | 183500000X | 051.294009 | IL |
Addresses
Primary practice location
4700 Schaefer Rd
Suite 340
Dearborn, MI 48126-3655
Mailing address
4700 Schaefer Rd
Suite 340
Dearborn, MI 48126-3655
Phone (313) 827-5565
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051.294009 | IL | MD | Pharmacist |
| 5302025437 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361836800000",
"number": "1275690133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 SCHAEFER RD",
"address_2": "SUITE 340",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481263655",
"telephone_number": "313-827-5565",
"fax_number": "313-429-5165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 SCHAEFER RD",
"address_2": "SUITE 340",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481263655",
"telephone_number": "313-827-5565",
"fax_number": "313-429-5165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELTZ",
"first_name": "BRIAN",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-02",
"last_updated": "2013-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302025437",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051.294009",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.