Active NPI
St Joseph Mercy Professional Pharmacy
- Specialty Pharmacy
- Pontiac, MI
National Provider Identifier
1710073010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialty Pharmacy
- License
- 5301007139
- Legal business name
- ST JOSEPH MERCY PROFESSIONAL PHARMACY
- Practice address
- 44405 Woodward Ave
Pontiac, MI 48341-5023 - Phone
- (248) 452-5357
- Fax
- (248) 452-5292
- NPI assigned
- Oct 5, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Phillip J Wein, PHARMACIST
- Title
- Manager, Pharmacy Services
- Phone
- (248) 858-3053
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 5301007139 | MI | |
| Home Infusion Therapy Pharmacy | 3336H0001X | 5301007139 | MI | |
| Specialty Pharmacy | 3336S0011X | 5301007139 | MI | Primary |
Addresses
Primary practice location
44405 Woodward Ave
Pontiac, MI 48341-5023
Mailing address
44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 858-3053
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2360876 | Other | MI | NABP/NCPDP # |
| 4168904 | Medicaid | MI | |
| 4168922 | Medicaid | MI | |
| 5301007139 | Other | MI | MICHIGAN LICENSE # |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1710073010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVE",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415023",
"telephone_number": "248-858-3053",
"fax_number": "248-858-3010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVE",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415023",
"telephone_number": "248-452-5357",
"fax_number": "248-452-5292"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST JOSEPH MERCY PROFESSIONAL PHARMACY",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-05",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "WEIN",
"authorized_official_first_name": "PHILLIP",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "MANAGER, PHARMACY SERVICES",
"authorized_official_telephone_number": "248-858-3053",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "PHARMACIST"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MI",
"license": "5301007139",
"primary": false
},
{
"code": "3336H0001X",
"taxonomy_group": "",
"desc": "Pharmacy, Home Infusion Therapy Pharmacy",
"state": "MI",
"license": "5301007139",
"primary": false
},
{
"code": "3336S0011X",
"taxonomy_group": "",
"desc": "Pharmacy, Specialty Pharmacy",
"state": "MI",
"license": "5301007139",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NABP/NCPDP #",
"identifier": "2360876",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4168904",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4168922",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHIGAN LICENSE #",
"identifier": "5301007139",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.