Gateway Pharmacy Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301007360 Issued in MI

Legal business name

GATEWAY PHARMACY INC.

Doing business as

gateway pharmacy inc.

Practice address

15690 Joy Rd
Detroit, MI 48228

Phone

(313) 835-9999

Fax

(313) 835-6539

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mustafa A Alsamarae, RPH

Title

Officer

Phone

(313) 835-9999

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• gateway pharmacy inc. Doing business as

Locations

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483488000000",
    "number": "1619025715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15690 JOY RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48228",
            "telephone_number": "313-835-9999",
            "fax_number": "313-835-6539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15690 JOY RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48228",
            "telephone_number": "313-835-9999",
            "fax_number": "313-835-6539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY PHARMACY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2017-01-04",
        "status": "A",
        "authorized_official_last_name": "ALSAMARAE",
        "authorized_official_first_name": "MUSTAFA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "313-835-9999",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301007360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2362488",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "gateway pharmacy inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Gateway OBGYN Associates PLLC
• Gateway Vision Services, Inc.
• Gateway-Detroit East
• Sandra Denise Gatewood
• Raechele C. Gathers, M.D.
• Tyler Gathman

• Community/Retail Pharmacy in Detroit, MI
• Providers in Detroit, 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 Jan 4, 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.