Organization Active NPI

The Pharmacy Shop

  • Community/Retail Pharmacy
  • Madison Heights, MI
National Provider Identifier
1700979655
Registry record updated Jan 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301007600 Issued in MI
Legal business name
THE PHARMACY SHOP
Practice address
28411 Dequindre
Madison Heights, MI 48071
Phone
(248) 591-5555
Fax
(248) 591-7136
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2019

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

Authorized official

Name
Mr. Jeff M Chehab, R.PH
Title
Pharmacist
Phone
(248) 591-5555

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X 5302027828 MI
Community/Retail Pharmacy 3336C0003X 5301007600 MI Primary

Addresses

Primary practice location

28411 Dequindre
Madison Heights, MI 48071

Mailing address

28411 Dequindre
Madison Heights, MI 48071
Phone (248) 591-5555

Other names 2

  • The Pharmacy SHop Doing business as
  • none Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930072031 MI DME Supplier - PharmacyDME Supplier - Orthotic PersonnelDME Supplier - Oxygen & EquipmentDME Supplier - Prosthetic PersonnelDME Supplier - Medical Supply Company With Registered Pharmacist 3375757941 Practice locations: Madison Heights, MI
O20201214000672 MI Part B Supplier - Pharmacy 3375757941 Practice locations: Madison 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.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2207966Pharmacy Shop, the28411 Dequindre Road, Madison Heights, MI 48071Certificate of waiverJan 3, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Pharmacy Shop Inc28411 Dequindre Rd, Madison Heights, MI 48071-3055(248) 591-5555 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Canes and/or Crutches|Wheelchairs (Standard Power)|Orthoses: Off-The-Shelf|Nebulizer Equipment and/or Supplies|Diabetic Shoes and Inserts Does not accept assignmentParticipating since Oct 31, 2002

National Provider Directory

National Provider Directory

Locations

28411 Dequindre Rd
Madison Heights, MI 48071
Phone (248) 591-5555

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548892800000",
    "number": "1700979655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28411 DEQUINDRE",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "48071",
            "telephone_number": "248-591-5555",
            "fax_number": "248-591-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28411 DEQUINDRE",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "48071",
            "telephone_number": "248-591-5555",
            "fax_number": "248-591-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PHARMACY SHOP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2019-01-31",
        "status": "A",
        "authorized_official_last_name": "CHEHAB",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "248-591-5555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302027828",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301007600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Pharmacy SHop",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "none",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Madison Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2019; 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.