STP Rex LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

STP REX LLC

Practice address

9934 Harper Ave
Detroit, MI 48213-3110

Phone

(313) 921-3536

NPI assigned

Nov 8, 2020

Organization subpart

No

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

Authorized official

Name

Candi Tolf

Title

3Rd Party Coordinator

Phone

(248) 963-7979

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rexall Detroit Pharmacy Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

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

{
    "created_epoch": "1604793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1346841012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 ORCHARD LAKE RD STE 180-183",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483231604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9934 HARPER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133110",
            "telephone_number": "313-921-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STP REX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-08",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "TOLF",
        "authorized_official_first_name": "CANDI",
        "authorized_official_title_or_position": "3RD PARTY COORDINATOR",
        "authorized_official_telephone_number": "248-963-7979"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLEXSCRIPT",
            "identifier": "FSRX9938785",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "detroit@rexallus.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "9934 Harper Ave",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482133110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Rexall Detroit Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rexall Detroit Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Stovall
• Tonie Stovall
• Sarleatha La'Shay Stove
• Carolyn B Stover, APRN-BC
• Diana Stoyanovitch, LLMSW
• Jessica Kay Strabbing, AU.D.
• Sarita Shauntel Strait
• Vernon F. Strand, M.D.
• Lukas S Strang, MD
• Derrick Strange

• Community/Retail Pharmacy in Detroit, MI
• Providers in Detroit, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.