Red Cap Pharmacy 002, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

054.020247 Issued in IL

Legal business name

RED CAP PHARMACY 002, LLC

Practice address

4640 S Halsted St Ste F
Chicago, IL 60609-4414

Phone

(313) 737-0691

Fax

(313) 286-0220

NPI assigned

Mar 9, 2017

Organization subpart

No

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

Authorized official

Name

Mike Shehadi

Title

Ceo

Phone

(313) 737-0691

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Red Cap Pharmacy 003 LLC Doing business as

Locations

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489017600000",
    "number": "1609317759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37484 INTERCHANGE DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483351023",
            "telephone_number": "313-737-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 S HALSTED ST STE F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606094414",
            "telephone_number": "313-737-0691",
            "fax_number": "313-286-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED CAP PHARMACY 002, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "status": "A",
        "authorized_official_last_name": "SHEHADI",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-737-0691"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": "054.020247",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2168134",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Cap Pharmacy 003 LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Chicago, IL
• Providers in Chicago, IL by specialty
• Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; 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.