Livernois Express Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301008192 Issued in MI

Legal business name

LIVERNOIS EXPRESS PHARMACY

Doing business as

Livernois Express Pharmacy

Practice address

15530 Puritan St
Detroit, MI 48227-2342

Phone

(313) 659-1622

Fax

(313) 659-1621

NPI assigned

Jul 30, 2006

Last updated

Jan 20, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

C Oliver Duru, RPH

Title

Pharmacist/Owner

Phone

(313) 659-1622

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• LIVERNOIS EXPRESS PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453248000000",
    "number": "1417962028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15530 PURITAN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482272342",
            "telephone_number": "313-659-1622",
            "fax_number": "313-659-1621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15530 PURITAN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482272342",
            "telephone_number": "313-659-1622",
            "fax_number": "313-659-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVERNOIS EXPRESS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2016-01-20",
        "status": "A",
        "authorized_official_last_name": "DURU",
        "authorized_official_first_name": "C OLIVER",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "313-659-1622",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301008192",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2041990",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2367553",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIVERNOIS EXPRESS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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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 Jan 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.