NPIMap

Organization Active NPI

Great Lakes Pharmacies I Inc

Doing business as Village Pharmacy

  • Long Term Care Pharmacy
  • Warren, MI
National Provider Identifier
1619510328
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
GREAT LAKES PHARMACIES I INC
Doing business as
Village Pharmacy
Practice address
6213 Chicago Rd Ste 200
Warren, MI 48092-1697
Phone
(586) 751-7979
Fax
(586) 751-0809
NPI assigned
Oct 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Authorized official

Name
Robert Harb, RPH
Title
Owner/RPH
Phone
(248) 867-1683

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

6213 Chicago Rd Ste 200
Warren, MI 48092-1697

Mailing address

6213 Chicago Rd Ste 200
Warren, MI 48092-1697
Phone (586) 751-7979

Other names 1

  • Village Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Great Lakes Pharmacies I Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1619510328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6213 CHICAGO RD STE 200",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480921697",
            "telephone_number": "586-751-7979",
            "fax_number": "586-751-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6213 CHICAGO RD STE 200",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480921697",
            "telephone_number": "586-751-7979",
            "fax_number": "586-751-0809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES PHARMACIES I INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-25",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "HARB",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER/RPH",
        "authorized_official_telephone_number": "248-867-1683",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Village Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.