Detroit Medical Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301007748 Issued in MI

Legal business name

DETROIT MEDICAL PHARMACY INC

Practice address

500 E Warren Ave
Detroit, MI 48201-1436

Phone

(313) 831-2400

Fax

(313) 831-2445

NPI assigned

Nov 17, 2006

Organization subpart

No

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

Authorized official

Name

Mohamed Sohoubah, RPH

Title

Owner Pic

Phone

(313) 831-2400

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• DETROIT MEDICAL PHARMACY Doing business as

Locations

Practitioners 1

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

• Young On

  • Pharmacist
  • Detroit, MI
  • NPI 1629565114
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1457425977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011436",
            "telephone_number": "313-831-2400",
            "fax_number": "313-831-2445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011436",
            "telephone_number": "313-831-2400",
            "fax_number": "313-831-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETROIT MEDICAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "SOHOUBAH",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "OWNER PIC",
        "authorized_official_telephone_number": "313-831-2400",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301007748",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2365220",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2046547",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DETROIT MEDICAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Detroit Medical Center/Sinai Grace
• Detroit Medical Centre
• Detroit Medical Clinic PC
• Detroit Medical Consultants PC
• Detroit Medical Group, PLLC
• Detroit Medical Service PLC
• Detroit Meditation & Yoga
• Detroit Metro Medical
• Detroit Oral Surgery Specialists PLLC
• Detroit Peoples Community

• 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 18, 2017; 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.