Conant Plaza Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301007843 Issued in MI

Legal business name

CONANT PLAZA PHARMACY LLC

Doing business as

Conant Plaza Pharmacy

Practice address

3611 Carpenter St
Suite #3
Detroit, MI 48212-2784

Phone

(313) 366-1221

Fax

(313) 366-2947

NPI assigned

Jan 20, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Samir A Berri, RPH

Title

Manager

Phone

(313) 366-1221

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CONANT PLAZA PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1437202587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 CARPENTER ST",
            "address_2": "SUITE #3",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482122784",
            "telephone_number": "313-366-1221",
            "fax_number": "313-366-2947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 CARPENTER ST",
            "address_2": "SUITE #3",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482122784",
            "telephone_number": "313-366-1221",
            "fax_number": "313-366-2947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONANT PLAZA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-20",
        "last_updated": "2013-10-09",
        "status": "A",
        "authorized_official_last_name": "BERRI",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "313-366-1221",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301007843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2365600",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CONANT PLAZA 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 Oct 9, 2013; 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.