NPIMap

Organization Active NPI

Gbogbara Inc

Doing business as King Pharmacy

  • Community/Retail Pharmacy
  • Detroit, MI
National Provider Identifier
1609471135
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
GBOGBARA INC
Doing business as
King Pharmacy
Practice address
15200 Gratiot Ave
Detroit, MI 48205-1327
Phone
(313) 821-4449
Fax
(313) 332-0317
NPI assigned
Dec 2, 2020
Last updated
Jan 20, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
GBOGBARA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Authorized official

Name
Mr. Lenyie Ngbogbara, RPHNPI 1154854016
Title
President
Phone
(313) 331-8484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

15200 Gratiot Ave
Detroit, MI 48205-1327

Mailing address

6202 Golden LN
West Bloomfield, MI 48322-3271

Other names 1

  • King Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gbogbara Inc2 organizations share this tax ID, including this one
Part of
Gbogbara Inc

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611100800000",
    "number": "1609471135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6202 GOLDEN LN",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 GRATIOT AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482051327",
            "telephone_number": "313-821-4449",
            "fax_number": "313-332-0317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GBOGBARA INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GBOGBARA INC",
        "enumeration_date": "2020-12-02",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A",
        "authorized_official_last_name": "NGBOGBARA",
        "authorized_official_first_name": "LENYIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-331-8484",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "King Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "King Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.