NPIMap

Organization Active NPI

Highland Pharmacy LLC

Doing business as Highland Pharmacy

  • Community/Retail Pharmacy
  • Waterford, MI
National Provider Identifier
1558506451
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301009009 Issued in MI
Legal business name
HIGHLAND PHARMACY LLC
Doing business as
Highland Pharmacy
Practice address
4000 Highland Rd
Ste 113
Waterford, MI 48328-2167
Phone
(248) 977-1394
Fax
(248) 977-1395
NPI assigned
Dec 5, 2008
Last updated
Nov 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Authorized official

Name
Neil MehtaNPI 1982115697
Title
Owner
Phone
(248) 977-1394

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X 5301009009 MI
Multi-Specialty Clinic/Center 261QM1300X 5301009009 MI
Durable Medical Equipment & Medical Supplies 332B00000X 5301009009 MI
Community/Retail Pharmacy 3336C0003X 5301009009 MI Primary
Long Term Care Pharmacy 3336L0003X NU
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

4000 Highland Rd
Ste 113
Waterford, MI 48328-2167

Mailing address

4000 Highland Rd
Ste 113
Waterford, MI 48328-2167
Phone (248) 977-1394

Other identifiers 2

IdentifierTypeStateIssuer
2118084OtherPK
6030654MedicaidMI

Other names 1

  • Highland Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130402000166 MI DME Supplier - Pharmacy 6305903832 Practice locations: Waterford, MI
O20150803000060 MI Part B Supplier - Mass Immunization (Roster Biller Only) 6305903832 Practice locations: Waterford, MI

National Provider Directory

National Provider Directory

Member of 6

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1558506451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 HIGHLAND RD",
            "address_2": "STE 113",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282167",
            "telephone_number": "248-977-1394",
            "fax_number": "248-977-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 HIGHLAND RD",
            "address_2": "STE 113",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282167",
            "telephone_number": "248-977-1394",
            "fax_number": "248-977-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-05",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-977-1394"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "MI",
            "license": "5301009009",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MI",
            "license": "5301009009",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5301009009",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009009",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2118084",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6030654",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highland Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Highland Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.