Berkley Medical Center Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BERKLEY MEDICAL CENTER PHARMACY LLC

Practice address

1695 W 12 Mile Rd # 210
Berkley, MI 48072-2182

Phone

(248) 262-7679

NPI assigned

Feb 10, 2020

Last updated

Feb 10, 2020By 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

Dr. Hady Beydoun, PHARMD

Title

Owner

Phone

(313) 844-7447

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1568094332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27207 LAHSER RD STE 102",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480348470",
            "telephone_number": "248-262-7679",
            "fax_number": "248-262-7973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 W 12 MILE RD # 210",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480722182",
            "telephone_number": "248-262-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERKLEY MEDICAL CENTER PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "BEYDOUN",
        "authorized_official_first_name": "HADY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-844-7447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Computer",
            "affiliation": "N",
            "address_1": "1695 W 12 Mile Rd # 210",
            "city": "Berkley",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480722182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Community/Retail Pharmacy in Berkley, MI
• Providers in Berkley, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.