Active NPI
Erwyn Tabasan, PHARMD
- Pharmacist
- Southfield, MI
National Provider Identifier
1649921370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302413710
- Practice address
- 26901 Beaumont Blvd
Southfield, MI 48033-3849 - Phone
- (844) 874-3965
- NPI assigned
- Jan 13, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302413710 | MI | Primary |
Addresses
Primary practice location
26901 Beaumont Blvd
Southfield, MI 48033-3849
Mailing address
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302413710 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726963200000",
"number": "1649921370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 W 13 MILE RD",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480736712",
"telephone_number": "248-898-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26901 BEAUMONT BLVD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333849",
"telephone_number": "844-874-3965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABASAN",
"first_name": "ERWYN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-13",
"last_updated": "2024-09-22",
"certification_date": "2024-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302413710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.