Advanced Specialty RX LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

5301008902 Issued in MI

Legal business name

ADVANCED SPECIALTY RX LLC

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

Organization subpart

No

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

Authorized official

Name

Bassam Youssef

Title

Owner

Phone

(810) 230-8300

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Advanced Specialty Rx Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kaneez Zainab, RPH

  • Pharmacist
  • Flint, MI
  • NPI 1881489458
  NPD
• Abdul Mannan Khaja, RPH

  • Pharmacist
  • Flint, MI
  • NPI 1922681469
  NPD (past)

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125139",
            "state": null
        }
    ],
    "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"
        }
    ]
}

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• Long Term Care Pharmacy in Flint, MI
• Providers in Flint, MI by specialty
• Long Term Care Pharmacy in Michigan

• 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.