Redford Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009740 Issued in MI

Legal business name

REDFORD PHARMACY INC

Practice address

17364 Lahser Rd
Detroit, MI 48219-2348

Phone

(313) 532-5920

Fax

(313) 532-8224

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Mohammad EttaherNPI 1841055159

Title

Owner

Phone

(313) 532-8224

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Redford Pharmacy, Inc Doing business as

Locations

Practitioners 1

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

• Mohammad Ettaher

  • Pharmacist
  • Detroit, MI
  • NPI 1841055159
  NPD Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1659440352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17364 LAHSER RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482192348",
            "telephone_number": "313-532-5920",
            "fax_number": "313-532-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17364 LAHSER RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482192348",
            "telephone_number": "313-532-5920",
            "fax_number": "313-532-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDFORD PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "ETTAHER",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-532-8224"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2311239",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2311239",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redford Pharmacy, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sunil Sandadi Reddy, M.D.
• Redeemer Family Clinic
• Catrina Y Redfearn
• Redford Geriatric Village, Inc
• Redford Opco, LLC
• Redfoxx Non-Medical Homecare LLC
• Mikala Redgate
• Redicare Healthcare Services
• Redicare Home Health Service
• Redicare Home Health Service LLC

• Community/Retail Pharmacy in Detroit, MI
• Providers in Detroit, 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 Apr 26, 2012; 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.