Individual provider Active NPI

Wassem Mohamad Slaibe, RPH

  • Pharmacist
  • Jackson, MI
National Provider Identifier
1457993099
Registry record updated Oct 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302412118 Issued in MI
Practice address
1700 W Michigan Ave
Jackson, MI 49202-4005
Phone
(517) 817-0326
NPI assigned
Oct 15, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302412118 MI Primary

Addresses

Primary practice location

1700 W Michigan Ave
Jackson, MI 49202-4005

Mailing address

841 N John Daly Rd
Dearborn Heights, MI 48127-4103
Phone (313) 212-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302412118MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1457993099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 N JOHN DALY RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481274103",
            "telephone_number": "313-212-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492024005",
            "telephone_number": "517-817-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLAIBE",
        "first_name": "WASSEM",
        "middle_name": "MOHAMAD",
        "name_prefix": "Dr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-15",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302412118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; 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.