Gratiot Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301008550 Issued in MI

Legal business name

GRATIOT DRUG STORE INC

Practice address

3745 Gratiot Ave
Detroit, MI 48207-1867

Phone

(313) 579-2643

Fax

(313) 579-2636

NPI assigned

Nov 16, 2006

Organization subpart

No

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

Authorized official

Name

Ali Nasser, RPH

Title

President

Phone

(313) 999-4748

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• GRATIOT PHARMACY Doing business as

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1457424657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3745 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482071867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482071867",
            "telephone_number": "313-579-2643",
            "fax_number": "313-579-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRATIOT DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "NASSER",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-999-4748",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301008550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2369191",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2369191",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRATIOT 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 Nov 7, 2007; 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.