Individual provider Active NPI

Sandy Hakim

  • Pharmacist
  • Berkley, MI
National Provider Identifier
1720660509
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302413129 Issued in MI
Practice address
1715 Coolidge Hwy
Berkley, MI 48072-3040
Phone
(248) 546-9111
NPI assigned
Apr 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302413129 MI Primary

Addresses

Primary practice location

1715 Coolidge Hwy
Berkley, MI 48072-3040

Mailing address

4346 15 Mile Rd
Sterling HTS, MI 48310-5409
Phone (586) 854-2861

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5302413129MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Woodward Detroit CVS, L.L.C. PastSince Apr 25, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1720660509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4346 15 MILE RD",
            "city": "STERLING HTS",
            "state": "MI",
            "postal_code": "483105409",
            "telephone_number": "586-854-2861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 COOLIDGE HWY",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480723040",
            "telephone_number": "248-546-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKIM",
        "first_name": "SANDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302413129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.