Dearborn Fresh Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009774 Issued in MI

Legal business name

DEARBORN FRESH PHARMACY INC

Practice address

5472 Schaefer Rd
Dearborn, MI 48126-3223

Phone

(313) 584-4600

Fax

(313) 584-3784

NPI assigned

Mar 2, 2012

Organization subpart

No

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

Authorized official

Name

Nabil Hawily

Title

Owner

Phone

(313) 455-1592

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• New Max Family Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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

• Leila Fawaz

  • Community/Retail Pharmacy
  • Dearborn, MI
  • NPI 1144690736
  NPD (past)

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1699049080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13661 COLSON ST STE A",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263232",
            "telephone_number": "313-581-8801",
            "fax_number": "313-581-8802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5472 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263223",
            "telephone_number": "313-584-4600",
            "fax_number": "313-584-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEARBORN FRESH PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-02",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "HAWILY",
        "authorized_official_first_name": "NABIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-455-1592"
    },
    "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": "5301009774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2133820",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Max Family Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dearborn Family Dental LLC
• Dearborn Family Dentistry PC
• Dearborn Family Pharmacy
• Dearborn Family Pharmacy LLC
• Dearborn Family Smiles PLLC
• Dearborn Gastroenterology
• Dearborn Healthcare PC
• Dearborn Hearing AIDS Inc
• Dearborn Hearing Center, LLC.
• Dearborn Heart & Vascular Associates PLLC

• 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 23, 2022; 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.