Individual provider Active NPI

Maria Agostina Iannucci, RPH

  • Pharmacist
  • Sterling Heights, MI
National Provider Identifier
1508985755
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302027445 Issued in MI
Practice address
14500 Hall Rd
Sterling Heights, MI 48313-1229
Phone
(586) 247-2990
Fax
(586) 247-2983
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302027445 MI Primary

Addresses

Primary practice location

14500 Hall Rd
Sterling Heights, MI 48313-1229

Mailing address

43639 Trillium Dr
Sterling Heights, MI 48314-1951
Phone (586) 254-1403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302027445MIMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508985755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43639 TRILLIUM DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141951",
            "telephone_number": "586-254-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14500 HALL RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483131229",
            "telephone_number": "586-247-2990",
            "fax_number": "586-247-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNUCCI",
        "first_name": "MARIA",
        "middle_name": "AGOSTINA",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302027445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.