South Dearborn Pharmacy,Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301003724 Issued in MI

Legal business name

SOUTH DEARBORN PHARMACY,INC

Doing business as

south dearborn pharmacy

Practice address

9925 Dix
Suite # 106
Dearborn, MI 48120-1593

Phone

(313) 841-2272

Fax

(313) 841-6715

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mohammad Y Hamzeh, RPH

Title

President

Phone

(313) 841-2272

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• south dearborn pharmacy Doing business as

Locations

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484784000000",
    "number": "1609820836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9925 DIX",
            "address_2": "SUITE # 106",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201593",
            "telephone_number": "313-841-2272",
            "fax_number": "313-841-6715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9925 DIX",
            "address_2": "SUITE # 106",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201593",
            "telephone_number": "313-841-2272",
            "fax_number": "313-841-6715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH DEARBORN PHARMACY,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2017-01-19",
        "status": "A",
        "authorized_official_last_name": "HAMZEH",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-841-2272",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301003724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2540791",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "south dearborn pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Dearborn, MI
• Providers in Dearborn, MI by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.