Great American Associates LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009932 Issued in MI

Legal business name

GREAT AMERICAN ASSOCIATES LLC

Doing business as

Grant Pharmacy

Practice address

29355 Northwestern Hwy
Ste 220
Southfield, MI 48034-1053

Phone

(248) 799-3900

Fax

(248) 799-3992

NPI assigned

Oct 20, 2012

Last updated

Nov 29, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tony John Kokkatt, PHARM D

Title

President

Phone

(248) 799-3900

Specialties & licenses 3

Addresses

Other names 1

• Grant Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

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

{
    "created_epoch": "1350691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480377600000",
    "number": "1487907960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29355 NORTHWESTERN HWY STE 220",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341051",
            "telephone_number": "248-799-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29355 NORTHWESTERN HWY",
            "address_2": "STE 220",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341053",
            "telephone_number": "248-799-3900",
            "fax_number": "248-799-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT AMERICAN ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-20",
        "last_updated": "2016-11-29",
        "status": "A",
        "authorized_official_last_name": "KOKKATT",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-799-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009932",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MI",
            "license": "5301009932",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "MI",
            "license": "5301009932",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grant Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen E Gray, MSN, RN, CS, ONC
• Leanora T Gray, LLC, NCC
• Precious Gray
• Brenna Grazioli
• Great American Associates LLC (Grant pharmacy LTC)
• Great Expressions Dental Centers Douglas Dziuba DDS Inc (Great Expression Dental Centers)
• Great Lakes Children Center LLC
• Great Lakes Clinical Care Services LLC
• Great Lakes Dialysis West LLC (Dialysis Care Center Great Lakes West)
• Great Lakes Foot & Ankle Institute PLLC

• Community/Retail Pharmacy in Southfield, MI
• Providers in Southfield, 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 Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.