Prestige Specialty Pharmacy LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

PRESTIGE SPECIALTY PHARMACY LLC

Practice address

3739 15 Mile Rd
Sterling Heights, MI 48310

Phone

(877) 742-7621

Fax

(586) 883-9388

NPI assigned

May 14, 2018

Last updated

Jun 5, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amro Sharafeldin

Title

Ceo

Phone

(877) 742-7621

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Prestige Specialty Pharmacy2 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.

• Prestige Specialty Pharmacy LLC

  dba prestige specialty pharmacy

  • Mail Order Pharmacy
  • Sterling Heights, MI
  • NPI 1588142970
  NPD tax ID

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

{
    "created_epoch": "1526256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528156800000",
    "number": "1548750714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3739 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "48310",
            "telephone_number": "877-742-7621",
            "fax_number": "586-883-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3739 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "48310",
            "telephone_number": "877-742-7621",
            "fax_number": "586-883-9388"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3739 15 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483105358",
            "country_code": "US",
            "telephone_number": "877-742-7621",
            "fax_number": "586-883-9388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRESTIGE SPECIALTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-14",
        "last_updated": "2018-06-05",
        "status": "A",
        "authorized_official_last_name": "SHARAFELDIN",
        "authorized_official_first_name": "AMRO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "877-742-7621"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306340955",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2177646",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Long Term Care Pharmacy in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Long Term Care Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; 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.