Active NPI
Rogers E. a. Elebra, PHARM.D.
- Pharmacist
- Detroit, MI
National Provider Identifier
1336351097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302029605
- Practice address
- Detroit Health Depart - Pharmacy
1151 Taylor Street, 41 B
Detroit, MI 48202-1732 - Phone
- (313) 876-4013
- Fax
- (313) 876-0512
- NPI assigned
- May 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302029605 | MI | Primary |
Addresses
Primary practice location
Detroit Health Depart - Pharmacy
1151 Taylor Street, 41 B
Detroit, MI 48202-1732
Mailing address
4574 Larme Ave
Allen Park, MI 48101-3109
Phone (313) 724-3455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302029605 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336351097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4574 LARME AVE",
"city": "ALLEN PARK",
"state": "MI",
"postal_code": "481013109",
"telephone_number": "313-724-3455",
"fax_number": "313-724-3456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "DETROIT HEALTH DEPART - PHARMACY",
"address_2": "1151 TAYLOR STREET, 41 B",
"city": "DETROIT",
"state": "MI",
"postal_code": "482021732",
"telephone_number": "313-876-4013",
"fax_number": "313-876-0512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELEBRA",
"first_name": "ROGERS",
"middle_name": "E. A.",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302029605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.