NPIMap

Organization Active NPI

Glory Pharmacy- Joseph Campau LLC

Doing business as PharMor Pharmacy-Joseph Campau

  • Community/Retail Pharmacy
  • Hamtramck, MI
National Provider Identifier
1316281140
Registry record updated Nov 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301009939 Issued in MI
Legal business name
GLORY PHARMACY- JOSEPH CAMPAU LLC
Doing business as
PharMor Pharmacy-Joseph Campau
Practice address
9023 Joseph Campau St
Hamtramck, MI 48212-3726
Phone
(313) 871-2020
Fax
(313) 871-2028
NPI assigned
Nov 16, 2012
Last updated
Nov 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2015

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

Authorized official

Name
Mursala Ahmed, RPHNPI 1679707558
Title
Owner/Chief Pharmacist
Phone
(313) 871-2020

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 5301009939 MI Primary

Addresses

Primary practice location

9023 Joseph Campau St
Hamtramck, MI 48212-3726

Mailing address

2385 Northwestern Hwy
Suite 200
Southfield, MI 48075
Phone (248) 663-3380

Other identifiers 2

IdentifierTypeStateIssuer
2137624OtherPK
1316281140MedicaidMI

Other names 1

  • PharMor Pharmacy-Joseph Campau Doing business as

National Provider Directory

National Provider Directory

Locations

9023 Joseph Campau St
Hamtramck, MI 48212
Phone (313) 871-1010

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": "1353024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448409600000",
    "number": "1316281140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2385 NORTHWESTERN HWY",
            "address_2": "SUITE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48075",
            "telephone_number": "248-663-3380",
            "fax_number": "248-223-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9023 JOSEPH CAMPAU ST",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482123726",
            "telephone_number": "313-871-2020",
            "fax_number": "313-871-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORY PHARMACY- JOSEPH CAMPAU LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-16",
        "last_updated": "2015-11-25",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "MURSALA",
        "authorized_official_title_or_position": "OWNER/CHIEF PHARMACIST",
        "authorized_official_telephone_number": "313-871-2020",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2137624",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316281140",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PharMor Pharmacy-Joseph Campau",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hamtramck, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; 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.