NPIMap

Organization Active NPI

Advanced Specialty RX LLC

Doing business as Advanced Specialty Rx

  • Long Term Care Pharmacy
  • Flint, MI
National Provider Identifier
1295987253
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
5301008902 Issued in MI
Legal business name
ADVANCED SPECIALTY RX LLC
Doing business as
Advanced Specialty Rx
Practice address
4488 W Bristol Rd Ste 350
Flint, MI 48507-3111
Phone
(810) 232-2700
Fax
(888) 246-0436
NPI assigned
Oct 21, 2008
Last updated
Oct 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Authorized official

Name
Bassam YoussefNPI 1407013766
Title
Owner
Phone
(810) 230-8300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X 5301008902 MI Primary
Managed Care Organization Pharmacy 3336M0003X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

4488 W Bristol Rd Ste 350
Flint, MI 48507-3111

Mailing address

4488 W Bristol Rd Ste 350
Flint, MI 48507-3111
Phone (810) 232-2700

Other names 1

  • Advanced Specialty Rx Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200929000413 MI Part B Supplier - Pharmacy 2163855610 Practice locations: Flint, MI

National Provider Directory

National Provider Directory

Locations

4488 W Bristol Rd
Ste 350
Flint, MI 48507
Phone (810) 232-2700

4800 S Saginaw St
Ste 1675
Flint, MI 48507
Phone (810) 232-2700

Practitioners & affiliated clinicians

Practitioners 3

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": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1295987253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4488 W BRISTOL RD STE 350",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073111",
            "telephone_number": "810-232-2700",
            "fax_number": "888-246-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4488 W BRISTOL RD STE 350",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073111",
            "telephone_number": "810-232-2700",
            "fax_number": "888-246-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPECIALTY RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "YOUSSEF",
        "authorized_official_first_name": "BASSAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-230-8300"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MI",
            "license": "5301008902",
            "primary": true
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Specialty Rx",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Specialty Rx",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.