Maple Pharmacy, Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010400 Issued in MI

Legal business name

MAPLE PHARMACY, INC.

Practice address

5829 W Maple Rd Ste 129
West Bloomfield, MI 48322-2294

Phone

(248) 757-2503

Fax

(248) 757-2847

NPI assigned

Apr 14, 2014

Organization subpart

No

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

Authorized official

Name

Hengameh KhalediNPI 1295168862

Title

President

Phone

(248) 757-2503

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

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.

• Hengameh Khaledi, RPH

  • Pharmacist
  • West Bloomfield, MI
  • NPI 1295168862
  NPD Authorized official
• Hamid Sanjaghsaz, D.O.

  • Obstetrics & Gynecology Physician
  • Dearborn Heights, MI
  • NPI 1780671776
  NPD (past)

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415145600000",
    "number": "1356760730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5773 MILL POND CT",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222078",
            "telephone_number": "248-342-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5829 W MAPLE RD STE 129",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222294",
            "telephone_number": "248-757-2503",
            "fax_number": "248-757-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-14",
        "last_updated": "2014-11-05",
        "status": "A",
        "authorized_official_last_name": "KHALEDI",
        "authorized_official_first_name": "HENGAMEH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-757-2503"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5301010400",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301010400",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010400",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "MI",
            "license": "5301010400",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Manick
• Wilhelmina Manuel, PT
• Elisabeth R. Maodus, NP
• Maple Cardiology & Internal Medicine, PLLC
• Maple Home Health Care LLC
• Maple Psychiatric Associates, P.C.
• Maple-Drake Real Estate, LLC (Notting Hill of West Bloomfield)
• Nancy A. Maranto, AU.D
• Marc S Brodsky MD PC
• Amy Marcotte

• Community/Retail Pharmacy in West Bloomfield, MI
• Providers in West Bloomfield, 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 Nov 5, 2014; 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.