Individual provider Active NPI

Mehulkumar V Sureja, PHARMACIST

  • Pharmacist
  • Flint, MI
National Provider Identifier
1336473990
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302036815 Issued in MI
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, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
5302036815MIMDPharmacist
28RI03174800NJMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson City Pharmacy LLC Current Accepting new patients
Brothers 2 Pharmacy LLC CurrentSince Apr 24, 2022 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.

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.

Verify at the official NPI Registry.