Active NPI
Bormans Inc
Doing business as Farmer Jack Pharmacy
- Community/Retail Pharmacy
- Fenton, MI
National Provider Identifier
1376568931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- BORMANS INC
- Doing business as
- Farmer Jack Pharmacy
- Practice address
- 1380 N Leroy St
Fenton, MI 48430-2762 - Phone
- (810) 750-5558
- Fax
- (810) 750-5562
- NPI assigned
- Jul 13, 2006
- Last updated
- Sep 11, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Kijowski
- Title
- Pharmacy Specialist
- Phone
- (201) 571-8326
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 5301006583 | MI | |
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
1380 N Leroy St
Fenton, MI 48430-2762
Mailing address
1380 N Leroy St
Fenton, MI 48430-2762
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2356942 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 3356946 | Medicaid | MI |
Other names 1
- FARMER JACK PHARMACY
National Provider Directory
National Provider Directory- Tax ID family
- Bormans Inc
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba Food Emporium Pharmacy
- Community/Retail Pharmacy
- Grosse Pointe Woods, MI
- NPI 1164447728
Locations
1380 N Leroy St
Fenton, MI 48430
Phone (810) 750-5558
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1376568931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1380 N LEROY ST",
"city": "FENTON",
"state": "MI",
"postal_code": "484302762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1380 N LEROY ST",
"city": "FENTON",
"state": "MI",
"postal_code": "484302762",
"telephone_number": "810-750-5558",
"fax_number": "810-750-5562"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BORMANS INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-13",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "KIJOWSKI",
"authorized_official_first_name": "SUSAN",
"authorized_official_title_or_position": "PHARMACY SPECIALIST",
"authorized_official_telephone_number": "201-571-8326"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "MI",
"license": "5301006583",
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "2356942",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3356946",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "FARMER JACK PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fenton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.