Ma Home LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010645 Issued in MI

Legal business name

MA HOME LLC

Doing business as

NEW SAMARITAN PHARMACY

Practice address

5575 Conner St Ste 103
Detroit, MI 48213-6400

Phone

(313) 571-3095

Fax

(313) 571-3942

NPI assigned

Feb 5, 2014

Organization subpart

No

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

Authorized official

Name

Ahmad Sayed, PHARMD

Title

Owner

Phone

(313) 571-3095

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• NEW SAMARITAN PHARMACY Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1316361819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5575 CONNER ST STE 103",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482136400",
            "telephone_number": "313-571-3095",
            "fax_number": "313-571-3942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5575 CONNER ST STE 103",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482136400",
            "telephone_number": "313-571-3095",
            "fax_number": "313-571-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MA HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-05",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "SAYED",
        "authorized_official_first_name": "AHMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-571-3095",
        "authorized_official_credential": "PHARMD"
    },
    "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": "5301010645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7113359",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2150754",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "MAHOMEPHARMACY1@GMAIL.COM",
            "affiliation": "N",
            "endpointDescription": "BUISNESS EMAIL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5575 Conner St Ste 103",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482136400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "NEW SAMARITAN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NEW SAMARITAN PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Detroit, MI
• Providers in Detroit, 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 Aug 26, 2019; 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.