Michigan Specialty Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301009130 Issued in MI

Legal business name

MICHIGAN SPECIALTY PHARMACY LLC

Practice address

9801 Conant St Ste a
Hamtramck, MI 48212-3308

Phone

(313) 467-2130

Fax

(989) 755-7993

NPI assigned

Jun 5, 2009

Organization subpart

No

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

Authorized official

Name

Khaja Mohammed

Title

Owner

Phone

(313) 888-9921

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• FRJ FAMILY PHARMACY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Munawar Syed

  • Pharmacist
  • Saginaw, MI
  • NPI 1558896977
  NPD (past)

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1801022702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 CONANT ST STE A",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482123308",
            "telephone_number": "313-888-9921",
            "fax_number": "313-262-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 CONANT ST STE A",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482123308",
            "telephone_number": "313-467-2130",
            "fax_number": "989-755-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN SPECIALTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-05",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A",
        "authorized_official_last_name": "MOHAMMED",
        "authorized_official_first_name": "KHAJA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-888-9921"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301009130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2120572",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FRJ FAMILY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dianna Jean Minardi, O.D.
• Abdulhakeem Mohamed
• Bidoor Mohamed, RN, MSN, FNP
• Momu Property LLC

• Community/Retail Pharmacy in Hamtramck, MI
• Providers in Hamtramck, 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 Nov 3, 2023; 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.