Utica Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301011163 Issued in MI

Legal business name

UTICA PHARMACY INC

Practice address

49310 Van Dyke Ave Ste 100
Shelby Township, MI 48317-1337

Phone

(586) 884-7710

Fax

(586) 884-7780

NPI assigned

May 3, 2017

Organization subpart

No

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

Authorized official

Name

Swarup Patel, B.PHARMACYNPI 1164732533

Title

Pharmacist

Phone

(586) 745-3035

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Utica Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Swarup Patel, R.PH.

  • Pharmacist
  • Shelby Township, MI
  • NPI 1164732533
  NPD Authorized official
• Heather Graskewicz, PHARMD

  • Pharmacist
  • Shelby Township, MI
  • NPI 1447010038
  NPD (past)
• Anila Mathew

  • Pharmacist
  • Shelby Township, MI
  • NPI 1740039783
  NPD (past)

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1609302181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49310 VAN DYKE AVE",
            "address_2": "STE 100",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483171337",
            "telephone_number": "586-884-7710",
            "fax_number": "586-884-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49310 VAN DYKE AVE STE 100",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483171337",
            "telephone_number": "586-884-7710",
            "fax_number": "586-884-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTICA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-03",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SWARUP",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "586-745-3035",
        "authorized_official_credential": "B.PHARMACY"
    },
    "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": "5301011163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2169268",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609302181",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Utica Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brian Tyson, MD
• Farzana Uddin
• Emma E Uhler
• Arben Uldedaj, DDS
• David Alexander Untener
• Uzma Rehman DO PC
• Uzma Rehman DO PC
• Talli Lynn Vadnais, PTA
• John Vincent Valeri, DDS
• Shannon Valicevic

• Community/Retail Pharmacy in Shelby Township, MI
• Providers in Shelby Township, 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 Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.