Organization Active NPI

Woodward RX LLC

  • Community/Retail Pharmacy
  • Detroit, MI
National Provider Identifier
1376055079
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301010811 Issued in MI
Legal business name
WOODWARD RX LLC
Doing business as
Knight Drugs - DMC
Practice address
4501 Woodward Ave
Detroit, MI 48201-1890
Phone
(313) 832-5800
Fax
(313) 832-5802
NPI assigned
Nov 2, 2017
Organization subpart
Yes
Parent organization
WOODWARD MANAGEMENT INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Authorized official

Name
Candice Tolf
Title
3Rd Party Coordinator
Phone
(313) 751-7979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301010811 MI Primary

Addresses

Primary practice location

4501 Woodward Ave
Detroit, MI 48201-1890

Mailing address

6689 Orchard Lake Rd Ste 168
West Bloomfield, MI 48322-3404

Other identifiers 1

IdentifierTypeStateIssuer
FSRX3519444OtherFLEXSCRIPT

Other names 1

  • Knight Drugs - DMC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210512002131 MI Part B Supplier - Mass Immunization (Roster Biller Only) 2466861984 Practice locations: Detroit, MI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1376055079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6689 ORCHARD LAKE RD STE 168",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 WOODWARD AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011890",
            "telephone_number": "313-832-5800",
            "fax_number": "313-832-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODWARD RX LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WOODWARD MANAGEMENT INC",
        "enumeration_date": "2017-11-02",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "TOLF",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_title_or_position": "3RD PARTY COORDINATOR",
        "authorized_official_telephone_number": "313-751-7979"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLEXSCRIPT",
            "identifier": "FSRX3519444",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knight Drugs - DMC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

  • 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.