Organization Active NPI

Dura Corp

Doing business as The Medicine Shoppe

  • Community/Retail Pharmacy
  • Sterling Heights, MI
National Provider Identifier
1629183652
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
DURA CORP
Doing business as
The Medicine Shoppe
Practice address
3979 17 Mile Rd
Sterling Heights, MI 48310-6835
Phone
(586) 268-6266
Fax
(586) 268-6113
NPI assigned
Aug 20, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Rawan Khader, RPHNPI 1013068295
Title
Owner Pharmacist
Phone
(586) 268-6266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 5301006377 MI
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

3979 17 Mile Rd
Sterling Heights, MI 48310-6835

Mailing address

3979 17 Mile Rd
Sterling Heights, MI 48310-6835
Phone (586) 268-6266

Other identifiers 2

IdentifierTypeStateIssuer
2355382OtherOTHER ID NUMBER-COMMERCIAL NUMBER
3218681MedicaidMI

Other names 1

  • THE MEDICINE SHOPPE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930053572 MI DME Supplier - Pharmacy 6507987252 Practice locations: Sterling Heights, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Dura Corp3979 17 Mile Rd, Sterling Heights, MI 48310-6835(586) 268-6266 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Nebulizer Equipment and/or Supplies|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

3979 17 Mile Rd
Sterling Heights, MI 48310
Phone (586) 268-6266

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1629183652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3979 17 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483106835",
            "telephone_number": "586-268-6266",
            "fax_number": "586-268-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3979 17 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483106835",
            "telephone_number": "586-268-6266",
            "fax_number": "586-268-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DURA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KHADER",
        "authorized_official_first_name": "RAWAN",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "586-268-6266",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301006377",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2355382",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3218681",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE MEDICINE SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.