Park Medical Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009761 Issued in MI

Legal business name

PARK MEDICAL PHARMACY INC

Doing business as

Park Medical Pharmacy Inc.

Practice address

20720 Plymouth Rd
Detroit, MI 48228-1275

Phone

(313) 288-2203

NPI assigned

Nov 29, 2011

Organization subpart

No

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

Authorized official

Name

Maitham Alsharifi

Title

Pharmacist

Phone

(313) 651-5887

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Park Medical Pharmacy Inc. Doing business as

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418688000000",
    "number": "1508133968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20720 PLYMOUTH RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482281275",
            "telephone_number": "313-288-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20720 PLYMOUTH RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482281275",
            "telephone_number": "313-288-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK MEDICAL PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-29",
        "last_updated": "2014-12-16",
        "status": "A",
        "authorized_official_last_name": "ALSHARIFI",
        "authorized_official_first_name": "MAITHAM",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "313-651-5887"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2376095",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Medical Pharmacy Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Park Med Pharmacy LLC
• Park Medical RX LLC
• Park Shelton Pharmacy
• Andrew Ji Hoon Park, MD
• Hakmin Park, M.D.
• Hyunkyu Park, DMD

• 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 Dec 16, 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.