Medex Health Mart

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009554 Issued in MI

Legal business name

MEDEX HEALTH MART

Doing business as

Medex Health Mart

Practice address

13970 Wyoming St
Detroit, MI 48238-2334

Phone

(313) 397-2054

Fax

(313) 397-2160

NPI assigned

May 4, 2011

Last updated

Aug 8, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Imad Mohammad

Title

Pharmacy Manager

Phone

(313) 397-2054

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• MEDEX HEALTH MART Doing business as

Locations

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312761600000",
    "number": "1730471194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13970 WYOMING ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482382334",
            "telephone_number": "313-397-2054",
            "fax_number": "313-397-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13970 WYOMING ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482382334",
            "telephone_number": "313-397-2054",
            "fax_number": "313-397-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEX HEALTH MART",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-08-08",
        "status": "A",
        "authorized_official_last_name": "MOHAMMAD",
        "authorized_official_first_name": "IMAD",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "313-397-2054"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2375550",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDEX HEALTH MART",
            "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 Aug 8, 2011; 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.