Samuel Joseph Polina, PHARMD

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

5302414462 Issued in MI

Practice address

40777 Ann Arbor Rd E
Plymouth, MI 48170-4448

Phone

(260) 266-4480

NPI assigned

Jul 14, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722729600000",
    "number": "1336828532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40777 ANN ARBOR RD E",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704448",
            "telephone_number": "734-928-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40777 ANN ARBOR RD E",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704448",
            "telephone_number": "260-266-4480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14300 N Beck Rd",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MI",
            "postal_code": "481703377",
            "country_code": "US",
            "telephone_number": "734-453-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLINA",
        "first_name": "SAMUEL",
        "middle_name": "JOSEPH",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-14",
        "last_updated": "2024-08-04",
        "certification_date": "2024-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302414462",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26030345A",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "MI",
            "license": "5302414462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Plymouth Sunsal Dental, PLLC
• Plymouth Urgent Care PLLC
• Plymouth Urgent Care Walk-in Clinic LLC
• Katie Lynn Podeszwik
• Polaris Pharmacy Services of Michigan, LLC
• Canedra C Polk
• Tyler James Pollack, LMSW
• Blake Pols
• Lindsey Polum
• Renee Polzin

• Ambulatory Care Pharmacist in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Ambulatory Care Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2024; 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.