Mishawaka Family Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

60006269B Issued in IN

Legal business name

MISHAWAKA FAMILY PHARMACY LLC

Doing business as

Mishawaka Family Pharmacy

Practice address

611 E Douglas Rd
Ste 104
Mishawaka, IN 46545-1464

Phone

(574) 340-0388

NPI assigned

Sep 8, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Chawki Fakih, R.PH

Title

Pharmacist

Phone

(313) 443-5959

Specialties & licenses 1

Addresses

Other names 1

• Mishawaka Family Pharmacy Doing business as

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315440000000",
    "number": "1538440250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD",
            "address_2": "STE 104",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451464",
            "telephone_number": "574-340-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E DOUGLAS RD",
            "address_2": "STE 104",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451464",
            "telephone_number": "574-340-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISHAWAKA FAMILY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-08",
        "last_updated": "2011-09-08",
        "status": "A",
        "authorized_official_last_name": "FAKIH",
        "authorized_official_first_name": "CHAWKI",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "313-443-5959",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IN",
            "license": "60006269B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mishawaka Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Mishawaka, IN
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; 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.