Organization Active NPI

Novi Pharmacy LLC

  • Pharmacy
  • Novi, MI
National Provider Identifier
1295379667
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
NOVI PHARMACY LLC
Practice address
39575 W 10 Mile Rd Ste 203
Novi, MI 48375-2949
Phone
(248) 536-2020
Fax
(248) 536-2063
NPI assigned
Oct 29, 2019
Last updated
Feb 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

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

Authorized official

Name
Osamah AlkoshabNPI 1568005668
Title
Owner/Pharmacist
Phone
(248) 536-2020

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary

Addresses

Primary practice location

39575 W 10 Mile Rd Ste 203
Novi, MI 48375-2949

Mailing address

39575 W 10 Mile Rd Ste 203
Novi, MI 48375-2949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200407000176 MI Part B Supplier - Pharmacy 5597194993 Practice locations: Novi, MI

National Provider Directory

National Provider Directory

Locations

39575 W 10 Mile Rd
Ste 203
Novi, MI 48375
Phone (248) 536-2020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1295379667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39575 W 10 MILE RD STE 203",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39575 W 10 MILE RD STE 203",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483752949",
            "telephone_number": "248-536-2020",
            "fax_number": "248-536-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVI PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-29",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "ALKOSHAB",
        "authorized_official_first_name": "OSAMAH",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "248-536-2020"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

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

Verify at the official NPI Registry.