Organization Active NPI

Roc Rex LLC

Doing business as Rexall Rockwood Pharmacy

  • Community/Retail Pharmacy
  • Rockwood, MI
National Provider Identifier
1619578382
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
ROC REX LLC
Doing business as
Rexall Rockwood Pharmacy
Practice address
32825 Fort Rd
Rockwood, MI 48173-1157
Phone
(734) 379-6815
NPI assigned
Nov 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Authorized official

Name
Candi Tolf
Title
3Rd Party Coordinator
Phone
(248) 963-7979

Specialties & licenses 1

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

Addresses

Primary practice location

32825 Fort Rd
Rockwood, MI 48173-1157

Mailing address

4301 Orchard Lake Rd Ste 180-183
West Bloomfield, MI 48323-1604
Phone (248) 963-7979

Other identifiers 1

IdentifierTypeStateIssuer
FSRX4734652OtherFLEXSCRIPT

Other names 1

  • Rexall Rockwood Pharmacy Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rockwood@rexallus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210512002715 MI Part B Supplier - Mass Immunization (Roster Biller Only) 7810306354 Practice locations: Rockwood, MI

National Provider Directory

National Provider Directory

Locations

32825 Fort Rd
Rockwood, MI 48173
Phone (734) 379-6815

NPI Registry JSON

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

{
    "created_epoch": "1604793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1619578382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 ORCHARD LAKE RD STE 180-183",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483231604",
            "telephone_number": "248-963-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32825 FORT RD",
            "city": "ROCKWOOD",
            "state": "MI",
            "postal_code": "481731157",
            "telephone_number": "734-379-6815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROC REX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-08",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "TOLF",
        "authorized_official_first_name": "CANDI",
        "authorized_official_title_or_position": "3RD PARTY COORDINATOR",
        "authorized_official_telephone_number": "248-963-7979"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLEXSCRIPT",
            "identifier": "FSRX4734652",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rockwood@rexallus.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "32825 Fort Rd",
            "city": "Rockwood",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481731157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Rexall Rockwood Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rexall Rockwood Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.