NPIMap

Organization Active NPI

Wayne Campus Pharmacy LLC

  • Community/Retail Pharmacy
  • Detroit, MI
National Provider Identifier
1760767974
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301009673 Issued in MI
Legal business name
WAYNE CAMPUS PHARMACY LLC
Practice address
1131 W Warren Ave
Detroit, MI 48201-3601
Phone
(313) 833-6000
Fax
(313) 833-7519
NPI assigned
Oct 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Authorized official

Name
Mr. Raef Hamaed, RPH
Title
Co-Owner
Phone
(305) 794-4117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301009673 MI Primary

Addresses

Primary practice location

1131 W Warren Ave
Detroit, MI 48201-3601

Mailing address

1131 W Warren Ave
Detroit, MI 48201-3601
Phone (313) 833-6000

Other identifiers 1

IdentifierTypeStateIssuer
5301009673OtherMIPHARMACY LICENSE NUMBER

Other names 1

  • WAYNE CAMPUS PHARMACY Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490227200000",
    "number": "1760767974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482013601",
            "telephone_number": "313-833-6000",
            "fax_number": "313-833-7519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482013601",
            "telephone_number": "313-833-6000",
            "fax_number": "313-833-7519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE CAMPUS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-19",
        "last_updated": "2017-03-23",
        "status": "A",
        "authorized_official_last_name": "HAMAED",
        "authorized_official_first_name": "RAEF",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "305-794-4117",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE NUMBER",
            "identifier": "5301009673",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WAYNE CAMPUS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.