Active NPI
Cynthia K Mallin, R.PH, PHARM.D
- Pharmacist
- Farmington Hills, MI
National Provider Identifier
1568756484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302021729
- Practice address
- 30020 Grand River Ave
Target 0611 PRN Pharmacist
Farmington Hills, MI 48336-4722 - Phone
- (248) 477-1467
- NPI assigned
- Jun 8, 2011
- Sex
- Female
- Sole proprietor
- No
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 | 183500000X | 5302021729 | MI | Primary |
Addresses
Primary practice location
30020 Grand River Ave
Target 0611 PRN Pharmacist
Farmington Hills, MI 48336-4722
Mailing address
30020 Grand River Ave
Target 0611 PRN Pharmacist
Farmington Hills, MI 48336-4722
Phone (248) 477-1467
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
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302021729 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307491200000",
"number": "1568756484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30020 GRAND RIVER AVE",
"address_2": "TARGET 0611 PRN PHARMACIST",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483364722",
"telephone_number": "248-477-1467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30020 GRAND RIVER AVE",
"address_2": "TARGET 0611 PRN PHARMACIST",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483364722",
"telephone_number": "248-477-1467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLIN",
"first_name": "CYNTHIA",
"middle_name": "K",
"credential": "R.PH, PHARM.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-08",
"last_updated": "2011-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302021729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.