NPIMap

Organization Active NPI

St Clair Shore Pharmacy Mi LLC

  • Community/Retail Pharmacy
  • St Clair Shores, MI
National Provider Identifier
1306583786
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ST CLAIR SHORE PHARMACY MI LLC
Practice address
25014 Little Mack Avenue
St Clair Shores, MI 48080
Phone
(586) 359-6517
Fax
(586) 359-6523
NPI assigned
May 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Authorized official

Name
Hema Patel
Title
Owner
Phone
(888) 839-0929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

25014 Little Mack Avenue
St Clair Shores, MI 48080

Mailing address

25014 Little Mack Avenue
St Clair Shores, MI 48080
Phone (586) 359-6517

National Provider Directory

National Provider Directory
Tax ID family
RX Care of Mi3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1306583786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25014 LITTLE MACK AVENUE",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "48080",
            "telephone_number": "586-359-6517",
            "fax_number": "586-359-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25014 LITTLE MACK AVENUE",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "48080",
            "telephone_number": "586-359-6517",
            "fax_number": "586-359-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CLAIR SHORE PHARMACY MI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-17",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "HEMA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-839-0929"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.