Nine Mile RX, LLC.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

NINE MILE RX, LLC.

Practice address

717 E 9 Mile Rd
Ferndale, MI 48220-1986

Phone

(313) 622-4711

NPI assigned

Aug 21, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Kassem Khraizat

Title

Authorized Official

Phone

(313) 622-4711

Specialties & licenses 1

Addresses

Tax ID family

Nine Mile RX LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Nine Mile RX, LLC.

  • Long Term Care Pharmacy
  • Ferndale, MI
  • NPI 1134094873
  NPD tax ID

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1548093016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 E 9 MILE RD",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201986",
            "telephone_number": "313-622-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 E 9 MILE RD",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201986",
            "telephone_number": "313-622-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NINE MILE RX, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-21",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "KHRAIZAT",
        "authorized_official_first_name": "KASSEM",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "313-622-4711",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ashton Niedzwiecki
• Anna Niforos
• Nine Mile RX, LLC.
• Novacare Outpatient Rehabilitation East Inc
• Novacare Outpatient Rehabilitation East, Inc.
• Katherine L O'Connor-Price, LMSW
• Dawn Marie O'Connor, MA, MS, LLP
• O'Leary Psychotherapy Services LLC

• All providers in Ferndale, MI
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.