Manda Louise Fernandez, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302025457 Issued in MI

Practice address

3390 West
Trenton, MI 48183

Phone

(734) 676-6622

Fax

(734) 676-4166

NPI assigned

Oct 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Walnut Associates I LLC

  dba West Grange Pharmacy

  • Community/Retail Pharmacy
  • Trenton, MI
  • NPI 1003924465
  NPD (past)
• Walnut Associates I LLC

  dba West Grange Pharmacy

  • Long Term Care Pharmacy
  • Trenton, MI
  • NPI 1164093878
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578645545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15755 PLEASANT AVE",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011193",
            "telephone_number": "313-382-2338",
            "fax_number": "313-383-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3390 WEST",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "48183",
            "telephone_number": "734-676-6622",
            "fax_number": "734-676-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MANDA",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302025457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE NUMBER",
            "identifier": "5302025457",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madina Mustafa Fawaz, MD
• Wissam H Fawaz, BS PHARM
• Alexander James Fazekas, DDS
• Krista Feges, RPH
• Karen Feldman, LLC, SCL
• Katelyn Ferrell
• Mohammad Irtaza Fiaz, DO
• Salvatore John Finazzo, D.O
• Anna Yakovlevna Fleytman-Pope, D.O.
• Alan Fligiel, MD

• Pharmacist in Trenton, MI
• Providers in Trenton, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.