NPIMap

Organization Active NPI

Dearborn Family Pharmacy LLC

  • Long Term Care Pharmacy
  • Dearborn, MI
National Provider Identifier
1316290729
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
DEARBORN FAMILY PHARMACY LLC
Practice address
17000 Executive Plaza Dr
Suite 104
Dearborn, MI 48126-2610
Phone
(313) 982-3770
Fax
(313) 982-3771
NPI assigned
Oct 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

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

Authorized official

Name
Aiman Abueida
Title
Owner
Phone
(313) 523-5334

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 5301009879 MI
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

17000 Executive Plaza Dr
Suite 104
Dearborn, MI 48126-2610

Mailing address

17000 Executive Plaza Dr
Suite 104
Dearborn, MI 48126-2610
Phone (313) 982-3770

Other identifiers 1

IdentifierTypeStateIssuer
2377237OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Family Pharmacy LTC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dearborn Family Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1350950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411344000000",
    "number": "1316290729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 EXECUTIVE PLAZA DR",
            "address_2": "SUITE 104",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262610",
            "telephone_number": "313-982-3770",
            "fax_number": "313-982-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 EXECUTIVE PLAZA DR",
            "address_2": "SUITE 104",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262610",
            "telephone_number": "313-982-3770",
            "fax_number": "313-982-3771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEARBORN FAMILY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-23",
        "last_updated": "2014-09-22",
        "status": "A",
        "authorized_official_last_name": "ABUEIDA",
        "authorized_official_first_name": "AIMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-523-5334"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009879",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2377237",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Pharmacy LTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; 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.