NPIMap

Organization Active NPI

Fenton Pharmacy LLC

  • Community/Retail Pharmacy
  • Fenton, MI
National Provider Identifier
1609212927
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301010093 Issued in MI
Legal business name
FENTON PHARMACY LLC
Doing business as
Fenton Pharmacy
Practice address
305 N Leroy St Ste a
Fenton, MI 48430-2729
Phone
(810) 354-8500
Fax
(810) 354-8503
NPI assigned
May 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Authorized official

Name
Manish Patel
Title
Owner
Phone
(813) 304-2221

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 5301010093 MI Primary
Compounding Pharmacy 3336C0004X
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

305 N Leroy St Ste a
Fenton, MI 48430-2729

Mailing address

305 N. Leroy St
Suite a
Fenton, MI 48430
Phone (810) 354-8500

Other identifiers 1

IdentifierTypeStateIssuer
2140350OtherPK

Other names 1

  • Fenton Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fenton Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1609212927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 N. LEROY ST",
            "address_2": "SUITE A",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "48430",
            "telephone_number": "810-354-8500",
            "fax_number": "810-354-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 N LEROY ST STE A",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302729",
            "telephone_number": "810-354-8500",
            "fax_number": "810-354-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENTON PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-14",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MANISH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-304-2221"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010093",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140350",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fenton Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.