Active NPI
John S LTC Pharmacy Inc
Doing business as Shelby Family Pharmacy
- Community/Retail Pharmacy
- Shelby Township, MI
National Provider Identifier
1275998205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 5301010783
- Legal business name
- JOHN S LTC PHARMACY INC
- Doing business as
- Shelby Family Pharmacy
- Practice address
- 48887 Hayes Rd
Shelby Township, MI 48315-4405 - Phone
- (586) 461-2900
- Fax
- (586) 461-2464
- NPI assigned
- Dec 17, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rashunte Brown
- Title
- Pharmacist
- Phone
- (586) 461-2900
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 5301010783 | MI | Primary |
| Community/Retail Pharmacy | 3336C0003X | |||
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
48887 Hayes Rd
Shelby Township, MI 48315-4405
Mailing address
48887 Hayes Rd
Shelby Township, MI 48315-4405
Phone (586) 461-2900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275998205 | Medicaid | MI | |
| 2156098 | Other | PK |
Other names 1
- Shelby Family Pharmacy
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | shelbyfamilypharmacy.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201021000598 | MI | Part B Supplier - Mass Immunization (Roster Biller Only) | 7517387111 | Practice locations: Shelby Township, MI |
National Provider Directory
National Provider Directory- Tax ID family
- John S LTC Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba John S LTC Pharmacy
- Long Term Care Pharmacy
- Shelby Township, MI
- NPI 1346629615
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Clinton Township, MI
- NPI 1417535584
-
- Pharmacist
- Shelby Township, MI
- NPI 1043944804
-
- Pharmacist
- Shelby Township, MI
- NPI 1154159671
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450310400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1603152000000",
"number": "1275998205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48887 HAYES RD",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483154405",
"telephone_number": "586-461-2900",
"fax_number": "586-461-2464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48887 HAYES RD",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483154405",
"telephone_number": "586-461-2900",
"fax_number": "586-461-2464"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOHN S LTC PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2015-12-17",
"last_updated": "2020-10-20",
"certification_date": "2020-10-01",
"status": "A",
"authorized_official_last_name": "BROWN",
"authorized_official_first_name": "RASHUNTE",
"authorized_official_title_or_position": "PHARMACIST",
"authorized_official_telephone_number": "586-461-2900"
},
"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": "5301010783",
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0004X",
"taxonomy_group": "",
"desc": "Pharmacy, Compounding Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1275998205",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2156098",
"state": null
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "shelbyfamilypharmacy.com",
"affiliation": "N",
"endpointDescription": "website",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "48887 Hayes Rd",
"city": "Shelby Township",
"state": "MI",
"country_code": "US",
"postal_code": "483154405",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Shelby Family Pharmacy",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Shelby Family Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Shelby Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.