Bormans Inc
Organization Active NPI Community/Retail Pharmacy · Roseville, MI
NPI 1720003387 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1720003387
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- BORMANS INC
- Practice address
- 30851 Gratiot Ave
Roseville, MI 48066-1769 - Phone
- (586) 415-0682
- Fax
- (586) 415-0058
- NPI assigned
- Jul 13, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan Kijowski
- Title
- Pharmacy Specialist
- Phone
- (201) 571-8326
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Bormans Inc
Locations
30851 Gratiot Ave
Roseville, MI 48066
Phone (586) 415-0682
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 5301006791 | MI | |
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
30851 Gratiot Ave
Roseville, MI 48066-1769
Mailing address
30851 Gratiot Ave
Roseville, MI 48066-1769
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2358249 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| 3469879 | Medicaid | MI |
Other names
- FARMER JACK PHARMACY
Other providers in Roseville, MI
- Pamela Ann Blair
- Blue Water Counseling and Wellness Center, Inc.
- Paul S Blunden
- Giovanni Bollini
- Heidi Boothby
- Amanda Bour
- Earl Benjamin Boyd III
- Hillary Brass
- Rebecca L Bremer
- Kelsey Anne Brengman
All providers in Roseville, MI · Community/Retail Pharmacy in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.