Canfield Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CANFIELD PHARMACY LLC

Practice address

4673 Conner St
Detroit, MI 48215-2028

Phone

(313) 458-7529

Fax

(313) 458-7547

NPI assigned

Sep 10, 2020

Organization subpart

No

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

Authorized official

Name

Faris Mazen Gammoh, PHARM DNPI 1205454477

Title

Owner

Phone

(313) 458-7529

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

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

• Faris Mazen Gammoh, PHARM D

  • Pharmacist
  • Sterling Heights, MI
  • NPI 1205454477

  Community/Retail Pharmacy

  NPD Authorized official
• Justin Haddad

  • Pharmacist
  • Detroit, MI
  • NPI 1689255739
  NPD

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599696000000",
    "number": "1487269122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4673 CONNER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152028",
            "telephone_number": "313-458-7529",
            "fax_number": "313-458-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4673 CONNER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152028",
            "telephone_number": "313-458-7529",
            "fax_number": "313-458-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANFIELD PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "GAMMOH",
        "authorized_official_first_name": "FARIS",
        "authorized_official_middle_name": "MAZEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-458-7529",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Camper, RN
• Cecilia Canale
• Caroline Jean Canavan
• Danielle Candela
• Steven Craig Candela, LMSW
• Jamaal Edward Cann
• Nicole S Cann
• Matthew Cannavo, D.M.D
• Carissa Cannon
• Christopher John Cannon, PHD

• 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 Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.