Active NPI
Mehulkumar V Sureja, PHARMACIST
- Pharmacist
- Flint, MI
National Provider Identifier
1336473990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302036815
- Practice address
- 4801 Fenton Rd
Flint, MI 48507-3321 - Phone
- (810) 820-8685
- Fax
- (810) 963-2887
- NPI assigned
- Sep 29, 2009
- Last updated
- Jan 9, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03174800 | NJ | |
| Pharmacist | 183500000X | 5302036815 | MI | Primary |
Addresses
Primary practice location
4801 Fenton Rd
Flint, MI 48507-3321
Mailing address
4801 Fenton Rd
Flint, MI 48507-3321
Phone (810) 820-8685
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302036815 | MI | MD | Pharmacist |
| 28RI03174800 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bronson City Pharmacy LLC | Current | Accepting new patients | |
| Brothers 2 Pharmacy LLC | Current | Accepting new patients | |
| Pontiac Pharmacy LLC | Current | Accepting new patients |
Locations
4801 Fenton Rd
Flint, MI 48507
Phone (810) 820-8685
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Big Brothers Pharmacy
- Community/Retail Pharmacy
- Flint, MI
- NPI 1851961502
-
dba Bronson City Pharmacy
- Community/Retail Pharmacy
- Bronson, MI
- NPI 1528616273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736380800000",
"number": "1336473990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4801 FENTON RD",
"city": "FLINT",
"state": "MI",
"postal_code": "485073321",
"telephone_number": "810-820-8685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 FENTON RD",
"city": "FLINT",
"state": "MI",
"postal_code": "485073321",
"telephone_number": "810-820-8685",
"fax_number": "810-963-2887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUREJA",
"first_name": "MEHULKUMAR",
"middle_name": "V",
"name_prefix": "Mr.",
"credential": "PHARMACIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-29",
"last_updated": "2025-01-09",
"certification_date": "2025-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI03174800",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302036815",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.