Dearborn Community Care Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301011007 Issued in MI

Legal business name

DEARBORN COMMUNITY CARE PHARMACY LLC

Practice address

15120 Michigan Ave
Dearborn, MI 48126-3768

Phone

(313) 558-2121

Fax

(313) 558-2020

NPI assigned

Sep 30, 2016

Organization subpart

No

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

Authorized official

Name

Nabil Mohsen Mohsen Al-Subari, RPH

Title

Member

Phone

(313) 558-2121

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486252800000",
    "number": "1629527734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15120 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263768",
            "telephone_number": "313-558-2121",
            "fax_number": "313-558-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15120 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263768",
            "telephone_number": "313-558-2121",
            "fax_number": "313-558-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEARBORN COMMUNITY CARE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-30",
        "last_updated": "2017-02-05",
        "status": "A",
        "authorized_official_last_name": "AL-SUBARI",
        "authorized_official_first_name": "NABIL",
        "authorized_official_middle_name": "MOHSEN MOHSEN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "313-558-2121",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301011007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Dearborn, MI
• Providers in Dearborn, 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 Feb 5, 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.