Integrated Drug Management

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5315052908 Issued in MI

Legal business name

INTEGRATED DRUG MANAGEMENT

Practice address

26541 Plymouth Rd
Redford, MI 48239-2214

Phone

(313) 543-3414

Fax

(313) 543-3416

NPI assigned

Sep 27, 2011

Organization subpart

No

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

Authorized official

Name

Faustina Iroha

Title

Ceo

Phone

(248) 943-1123

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• IDM PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1316220155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26541 PLYMOUTH RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482392214",
            "telephone_number": "313-543-3414",
            "fax_number": "313-543-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26541 PLYMOUTH RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482392214",
            "telephone_number": "313-543-3414",
            "fax_number": "313-543-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED DRUG MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-27",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "IROHA",
        "authorized_official_first_name": "FAUSTINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-943-1123"
    },
    "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": "5315052908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2132642",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316220155",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IDM PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Redford, MI
• Providers in Redford, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.