Med Mart Pharmacy 1 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MED MART PHARMACY 1 LLC

Practice address

25850 Eureka Rd
Taylor, MI 48180-4924

Phone

(313) 283-2000

Fax

(313) 914-4699

NPI assigned

Oct 1, 2018

Last updated

Dec 20, 2021By 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

Ali BerryNPI 1760856264

Title

RPH

Phone

(734) 992-8488

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Ali A Berry

  • Pharmacist
  • Dearborn Heights, MI
  • NPI 1760856264
  NPD Authorized official

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1568947018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13001 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263553",
            "telephone_number": "313-283-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25850 EUREKA RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481804924",
            "telephone_number": "313-283-2000",
            "fax_number": "313-914-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED MART PHARMACY 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-01",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "RPH",
        "authorized_official_telephone_number": "734-992-8488"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568947018",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shianna Marie McLeain, LMT
• Diane Mary McLellan, DDS
• Rachel McManamon
• Connor McNamee, MD
• MD Health Care LLC (MD Health Care)
• Med Mart Pharmacy LLC
• Medilodge of Taylor, Inc.
• Medsupply Corporation, Inc.
• Diana Mehdi
• Virendra Sinha Mehta, M.D.

• Community/Retail Pharmacy in Taylor, MI
• Providers in Taylor, 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 Dec 20, 2021; 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.