GST Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009773 Issued in MI

Legal business name

GST PHARMACY LLC

Practice address

13205 Dexter Ave
Detroit, MI 48238-3328

Phone

(313) 931-3301

Fax

(313) 931-3304

NPI assigned

Mar 28, 2012

Organization subpart

No

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

Authorized official

Name

Valerie Jones

Title

Owner/Pharmacy Manager

Phone

(313) 704-5335

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jordan's Discount Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335744000000",
    "number": "1750657391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13205 DEXTER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482383328",
            "telephone_number": "313-931-3301",
            "fax_number": "313-931-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13205 DEXTER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482383328",
            "telephone_number": "313-931-3301",
            "fax_number": "313-931-3304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GST PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-04-30",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "OWNER/PHARMACY MANAGER",
        "authorized_official_telephone_number": "313-704-5335"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2376691",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jordan's Discount Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meredith Grycki, PHARMD
• Walter Andrew Gryczewski Jr., MD
• David John Gryniewicz, MD
• Cynthia Grywalski, M.A., CCC-SLP
• GSP Global LLC
• Cristy A. Guagenti, CPNP
• Hui Guan, MD, PHD
• Guardian Angel Adult Services 2 Inc
• Guardian Angels Adult Living LLC
• Guardian Angels Res. SVCS Ministries

• 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 Apr 30, 2012; 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.