Active NPI
Benedicto Braganza
- Pharmacist
- Warren, MI
National Provider Identifier
1598301319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302035664
- Practice address
- 26233 Hoover Rd
Warren, MI 48089-1100 - Phone
- (586) 754-1191
- Fax
- (586) 754-0623
- NPI assigned
- Nov 27, 2019
- Last updated
- Nov 27, 2019
- Sex
- Male
- 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 | 5302035664 | MI | Primary |
Addresses
Primary practice location
26233 Hoover Rd
Warren, MI 48089-1100
Mailing address
49461 Oxley Rd
Macomb, MI 48044-1520
Phone (586) 864-3787
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 |
|---|---|---|---|
| 5302035664 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Co of Michigan | Past | Accepting new patients | |
| Kroger Co of Michigan | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574812800000",
"number": "1598301319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49461 OXLEY RD",
"city": "MACOMB",
"state": "MI",
"postal_code": "480441520",
"telephone_number": "586-864-3787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26233 HOOVER RD",
"city": "WARREN",
"state": "MI",
"postal_code": "480891100",
"telephone_number": "586-754-1191",
"fax_number": "586-754-0623"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAGANZA",
"first_name": "BENEDICTO",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-27",
"last_updated": "2019-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302035664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.