Active NPI
Amanda Hermiz
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Shelby Township, MI
National Provider Identifier
1568096253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 5302412294
- Practice address
- 2058 25 Mile Rd
Shelby Township, MI 48316-1096 - Phone
- (248) 651-1039
- NPI assigned
- Mar 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 5302412294 | MI | Primary |
Addresses
Primary practice location
2058 25 Mile Rd
Shelby Township, MI 48316-1096
Mailing address
49191 Clinton Terrace Dr
Macomb, MI 48044-9704
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302412294 | MI | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583193600000",
"number": "1568096253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49191 CLINTON TERRACE DR",
"city": "MACOMB",
"state": "MI",
"postal_code": "480449704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2058 25 MILE RD",
"city": "SHELBY TOWNSHIP",
"state": "MI",
"postal_code": "483161096",
"telephone_number": "248-651-1039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMIZ",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-03",
"last_updated": "2020-03-03",
"certification_date": "2020-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "MI",
"license": "5302412294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelby Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.