Active NPI
St Joseph Mercy Professional Pharmacy
- Home Infusion Therapy Pharmacy
- Pontiac, MI
National Provider Identifier
1508909847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Infusion Therapy Pharmacy
- Legal business name
- ST JOSEPH MERCY PROFESSIONAL PHARMACY
- Practice address
- 44405 Woodward Ave
B116
Pontiac, MI 48341-5023 - Phone
- (248) 305-7985
- Fax
- (248) 305-8677
- NPI assigned
- Feb 15, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Phil Wein
- Title
- Pharmacy Manager
- Phone
- (248) 858-3053
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Infusion Therapy Pharmacy | 3336H0001X | Primary |
Addresses
Primary practice location
44405 Woodward Ave
B116
Pontiac, MI 48341-5023
Mailing address
PO Box 3470
Farmington Hills, MI 48333-3470
Phone (248) 305-7985
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4168922 | Medicaid | MI | |
| OF300520 | Other | MI | BCBS HIT |
| OF316770 | Other | MI | BCBS DME |
National Provider Directory
National Provider DirectoryLocations
44405 Woodward Ave
#B116
Pontiac, MI 48341
Phone (248) 305-7985
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1508909847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3470",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483333470",
"telephone_number": "248-305-7985",
"fax_number": "248-305-8677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVE",
"address_2": "B116",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415023",
"telephone_number": "248-305-7985",
"fax_number": "248-305-8677"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST JOSEPH MERCY PROFESSIONAL PHARMACY",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-15",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "WEIN",
"authorized_official_first_name": "PHIL",
"authorized_official_title_or_position": "PHARMACY MANAGER",
"authorized_official_telephone_number": "248-858-3053"
},
"taxonomies": [
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4168922",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS HIT",
"identifier": "OF300520",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS DME",
"identifier": "OF316770",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.