Highland Park RX LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010815 Issued in MI

Legal business name

HIGHLAND PARK RX LLC

Doing business as

Knight Drugs - Highland Park

Practice address

13821 Woodward Ave Ste B
Detroit, MI 48203-3624

Phone

(313) 334-6722

Fax

(313) 334-6720

NPI assigned

Nov 2, 2017

Organization subpart

Yes

Parent organization

HIGHLAND PARK MANAGEMENT INCAs reported in NPPES

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

Authorized official

Name

Candice Tolf

Title

3Rd Party Coordinator

Phone

(313) 751-7979

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Knight Drugs - Highland Park Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

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

{
    "created_epoch": "1509580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1720590425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6689 ORCHARD LAKE RD STE 168",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13821 WOODWARD AVE STE B",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482033624",
            "telephone_number": "313-334-6722",
            "fax_number": "313-334-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND PARK RX LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HIGHLAND PARK MANAGEMENT INC",
        "enumeration_date": "2017-11-02",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "TOLF",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_title_or_position": "3RD PARTY COORDINATOR",
        "authorized_official_telephone_number": "313-751-7979"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLEXSCRIPT",
            "identifier": "FSRX8346512",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knight Drugs - Highland Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Sep 20, 2023; 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.