Organization Active NPI

Ferndale Family Pharmacy Inc

Doing business as Ferndale Family Pharmacy

  • Community/Retail Pharmacy
  • Ferndale, MI
National Provider Identifier
1346793817
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301010986 Issued in MI
Legal business name
FERNDALE FAMILY PHARMACY INC
Doing business as
Ferndale Family Pharmacy
Practice address
753 W 9 Mile Rd
Ferndale, MI 48220-1217
Phone
(248) 565-8031
Fax
(248) 565-8358
NPI assigned
Aug 1, 2016
Last updated
Sep 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Amin Khraizat
Title
Owner, Operating Officer, Ao
Phone
(313) 415-7754

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 5301010986 MI Primary

Addresses

Primary practice location

753 W 9 Mile Rd
Ferndale, MI 48220-1217

Mailing address

753 W 9 Mile Rd
Ferndale, MI 48220-1217
Phone (248) 565-8031

Other identifiers 2

IdentifierTypeStateIssuer
1346793817MedicaidMI
2162361OtherPK

Other names 1

  • FERNDALE FAMILY PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210413001580 MI Part B Supplier - Mass Immunization (Roster Biller Only) 2769890730 Practice locations: Ferndale, MI

National Provider Directory

National Provider Directory

Locations

733 W 9 Mile Rd
Ferndale, MI 48220
Phone (248) 565-8031

753 W 9 Mile Rd
Ferndale, MI 48220
Phone (248) 565-8031

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1346793817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 W 9 MILE RD",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201217",
            "telephone_number": "248-565-8031",
            "fax_number": "248-565-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 W 9 MILE RD",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201217",
            "telephone_number": "248-565-8031",
            "fax_number": "248-565-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERNDALE FAMILY PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-01",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "KHRAIZAT",
        "authorized_official_first_name": "AMIN",
        "authorized_official_title_or_position": "OWNER, OPERATING OFFICER, AO",
        "authorized_official_telephone_number": "313-415-7754"
    },
    "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": "5301010986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346793817",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2162361",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FERNDALE FAMILY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ferndale, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.