Mack Medical Management LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

MACK MEDICAL MANAGEMENT LLC

Practice address

430 Mack Ave
Detroit, MI 48201-2136

Phone

(248) 636-0071

NPI assigned

Sep 7, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Dimple Tripathi

Title

Owner

Phone

(734) 679-7688

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283817600000",
    "number": "1588971980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136",
            "telephone_number": "248-636-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136",
            "telephone_number": "248-636-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACK MEDICAL MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-07",
        "last_updated": "2010-09-07",
        "status": "A",
        "authorized_official_last_name": "TRIPATHI",
        "authorized_official_first_name": "DIMPLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-679-7688",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suhasini Macha, MD
• Zeinab Machhour
• Sarah Machowicz, MD
• Tenecia Machupa
• Mack Advanced Center, LLC
• Mack-Moross Pharmacy LLC (Remedy RX)
• Curtis McKinley Mack, MD
• Damone Denise Mack
• Kamiah Omokah Denies Mack
• Melissa Ann Mack, ACNP-BC

• Specialist in Detroit, MI
• Providers in Detroit, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; 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.