Mack-Moross Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009327 Issued in MI

Legal business name

MACK-MOROSS PHARMACY LLC

Practice address

22341 Moross Rd Ste R-113
Detroit, MI 48236-2116

Phone

(313) 642-1800

Fax

(313) 642-1802

NPI assigned

Mar 31, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Nasser Mozep, PHARMD

Title

Chief Pharmacist

Phone

(313) 642-1800

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Remedy RX Doing business as

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

Locations

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

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1275858441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22341 MOROSS RD STE R-113",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362116",
            "telephone_number": "313-642-1800",
            "fax_number": "313-642-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22341 MOROSS RD STE R-113",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362116",
            "telephone_number": "313-642-1800",
            "fax_number": "313-642-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACK-MOROSS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-31",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "MOZEP",
        "authorized_official_first_name": "NASSER",
        "authorized_official_title_or_position": "CHIEF PHARMACIST",
        "authorized_official_telephone_number": "313-642-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2373784",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Remedy RX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zeinab Machhour
• Sarah Machowicz, MD
• Tenecia Machupa
• Mack Advanced Center, LLC
• Mack Medical Management LLC
• Curtis McKinley Mack, MD
• Damone Denise Mack
• Kamiah Omokah Denies Mack
• Melissa Ann Mack, ACNP-BC
• Niesha Nicole Mack

• Community/Retail Pharmacy in Detroit, MI
• Providers in Detroit, 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 Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.