NPIMap

Organization Active NPI

Mercy Medical Pharmacy , LLC

  • Community/Retail Pharmacy
  • Roseville, MI
National Provider Identifier
1487052510
Registry record updated Dec 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MERCY MEDICAL PHARMACY , LLC
Practice address
19011 E 10 Mile Rd
B
Roseville, MI 48066-3901
Phone
(248) 802-0248
NPI assigned
Dec 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2014

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

Authorized official

Name
Abdallah Khashab
Title
Pharmd / Owner
Phone
(248) 802-0248

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

19011 E 10 Mile Rd
B
Roseville, MI 48066-3901

Mailing address

19011 E 10 Mile Rd
B
Roseville, MI 48066-3901

National Provider Directory

National Provider Directory

Locations

19011 E 10 Mile Rd
#B
Roseville, MI 48066
Phone (248) 802-0248

NPI Registry JSON

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

{
    "created_epoch": "1417737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417737600000",
    "number": "1487052510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19011 E 10 MILE RD",
            "address_2": "B",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480663901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19011 E 10 MILE RD",
            "address_2": "B",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480663901",
            "telephone_number": "248-802-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL PHARMACY , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-05",
        "last_updated": "2014-12-05",
        "status": "A",
        "authorized_official_last_name": "KHASHAB",
        "authorized_official_first_name": "ABDALLAH",
        "authorized_official_title_or_position": "PHARMD / OWNER",
        "authorized_official_telephone_number": "248-802-0248"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; 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.