Westside Pharmacy of Detroit, Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

004296 Issued in MI

Legal business name

WESTSIDE PHARMACY OF DETROIT, INC

Practice address

10600 W McNichols Rd
Detroit, MI 48221-2366

Phone

(313) 342-1555

Fax

(313) 342-2120

NPI assigned

Aug 11, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Renardo Gray, R.PH.NPI 1801963681

Title

President

Phone

(313) 342-1555

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Renardo Gray, R.PH.

  • Pharmacist
  • Detroit, MI
  • NPI 1801963681
  NPD Authorized official
• Damon Wright Jr., PHARMD

  • Pharmacist
  • Oak Park, MI
  • NPI 1538047980
  NPD (past)

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236038400000",
    "number": "1427050129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10600 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212366",
            "telephone_number": "313-342-1555",
            "fax_number": "313-342-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10600 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212366",
            "telephone_number": "313-342-1555",
            "fax_number": "313-342-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE PHARMACY OF DETROIT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-11",
        "last_updated": "2009-03-03",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "RENARDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-342-1555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "004296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1978150",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1685936",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackie Western, RN
• Mary Carmel Frances Solinap Westlake
• Jessica Westrick
• Westside Discount Pharmacy
• Westside Pharmacy of Detroit Inc
• Jessica Wetherbee, MS, CGC
• Debra A Wetzel, M.D.
• Jason E Wetzel
• Amanda Wewer, MD
• Karen Ann Wezner, PMHNP-BC, MED, RN

• Pharmacy in Detroit, MI
• Providers in Detroit, MI by specialty
• Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; 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.