Careland Pharmacy and Medical Supply PLLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CARELAND PHARMACY AND MEDICAL SUPPLY PLLC

Practice address

11919 E Warren Ave Ste C
Detroit, MI 48214-1641

Phone

(313) 499-1352

Fax

(313) 458-8989

NPI assigned

Mar 19, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Valaniche Aniche Ogbonnaya, PHARMD

Title

Director Pharmacy Operations

Phone

(313) 499-1352

Specialties & licenses 1

Addresses

Other identifiers 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": "1552953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552953600000",
    "number": "1396204129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11919 E WARREN AVE STE C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482141641",
            "telephone_number": "313-499-1352",
            "fax_number": "313-458-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11919 E WARREN AVE STE C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482141641",
            "telephone_number": "313-499-1352",
            "fax_number": "313-458-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARELAND PHARMACY AND MEDICAL SUPPLY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-19",
        "last_updated": "2019-03-19",
        "status": "A",
        "authorized_official_last_name": "OGBONNAYA",
        "authorized_official_first_name": "VALANICHE",
        "authorized_official_middle_name": "ANICHE",
        "authorized_official_title_or_position": "DIRECTOR  PHARMACY OPERATIONS",
        "authorized_official_telephone_number": "313-499-1352",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY, STATE OF MICHIGAN",
            "identifier": "5301011552",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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 Mar 19, 2019; 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.