Park Specialty Services LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010170 Issued in MI

Legal business name

PARK SPECIALTY SERVICES LLC

Doing business as

CHAMPAIGN FAMILY PHARMACY

Practice address

14726 Champaign Rd
Allen Park, MI 48101-1617

Phone

(313) 382-0000

Fax

(313) 382-0002

NPI assigned

Jun 3, 2013

Organization subpart

No

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

Authorized official

Name

Ghada Abdallah, RPH

Title

Owner

Phone

(313) 622-7465

Specialties & licenses 2

Addresses

Other names 1

• CHAMPAIGN FAMILY PHARMACY Doing business as

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388361600000",
    "number": "1477990117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14726 CHAMPAIGN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011617",
            "telephone_number": "313-382-0000",
            "fax_number": "313-382-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14726 CHAMPAIGN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011617",
            "telephone_number": "313-382-0000",
            "fax_number": "313-382-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK SPECIALTY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-03",
        "last_updated": "2013-12-30",
        "status": "A",
        "authorized_official_last_name": "ABDALLAH",
        "authorized_official_first_name": "GHADA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-622-7465",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5315062632",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHAMPAIGN FAMILY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pace Physical Therapy, P.C.
• Maureen Page
• Pamela Houck, LMSW, LLC
• Sarah Rose Pappas, RDN
• Park Pediatrics
• Michael Passera, DDS
• Dhara Prabhudas Patel, PT
• Mihir Patel
• Paul G. Riker DDS, PC., & Assoc.
• Eritha Alexia Pawley, LMT

• Community/Retail Pharmacy in Allen Park, MI
• Providers in Allen Park, 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 Dec 30, 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.