NPIMap

Organization Active NPI

Isidro II Inc

Doing business as University Pharmacy

  • Health Educator
  • Canton, MI
National Provider Identifier
1457815565
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Legal business name
ISIDRO II INC
Doing business as
University Pharmacy
Practice address
7288 N Sheldon Rd Ste a
Canton, MI 48187-2150
Phone
(734) 812-9129
Fax
(734) 629-1717
NPI assigned
Jan 23, 2019
Last updated
Jun 1, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ISIDRO II, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Authorized official

Name
Maria Christina YoungNPI 1740306778
Title
President
Phone
(734) 812-9129

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU
Health Educator 174H00000X NU Primary

Addresses

Primary practice location

7288 N Sheldon Rd Ste a
Canton, MI 48187-2150

Mailing address

PO Box 871819
Canton, MI 48187-7519
Phone (734) 812-9129

Other identifiers 5

IdentifierTypeStateIssuer
1295918274MedicaidMI
0P60030OtherMIPTAN
200810OtherDSME/ DPP
0P57520OtherMIMASS IMMUNIZATION
1740306778OtherMIRPH NPI

Other names 1

  • University Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Isidro II Inc3 organizations share this tax ID, including this one
Part of
Isidro II Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654041600000",
    "number": "1457815565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 871819",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481877519",
            "telephone_number": "734-812-9129",
            "fax_number": "734-629-1717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7288 N SHELDON RD STE A",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872150",
            "telephone_number": "734-812-9129",
            "fax_number": "734-629-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISIDRO II INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ISIDRO II, INC",
        "enumeration_date": "2019-01-23",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "CHRISTINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-812-9129"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295918274",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0P60030",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSME/ DPP",
            "identifier": "200810",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS IMMUNIZATION",
            "identifier": "0P57520",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RPH NPI",
            "identifier": "1740306778",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.