Uscg Detroit Pharmacy

Primary specialty

Military/U.S. Coast Guard PharmacyTaxonomy code 332000000X

Legal business name

USCG DETROIT PHARMACY

Doing business as

Uscg Detroit Pharmacy

Practice address

43401 N Jefferson Ave BLDG 825
Selfridge, MI 48045-5266

Phone

(586) 239-3005

Fax

(586) 239-5010

NPI assigned

Oct 26, 2021

Last updated

Oct 26, 2021By 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

Hector Morales

Title

Chief Dha Pass

Phone

(210) 536-6650

Specialties & licenses 1

Addresses

Other names 1

• USCG DETROIT PHARMACY Doing business as

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Crystal Jujuan Davis, R.D.H.

  • Dental Hygienist
  • Selfridge Angb, MI
  • NPI 1982963237
  NPD (past)
• Diana Lee Kott, RDH

  • Dental Hygienist
  • Selfridge Angb, MI
  • NPI 1528409117
  NPD (past)
• Dana Marie Kubinski, RDH

  • Dental Hygienist
  • Selfridge Angb, MI
  • NPI 1174814115
  NPD (past)

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1801550843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43401 N JEFFERSON AVE BLDG 825",
            "city": "SELFRIDGE",
            "state": "MI",
            "postal_code": "480455266",
            "telephone_number": "586-239-3005",
            "fax_number": "586-239-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43401 N JEFFERSON AVE BLDG 825",
            "city": "SELFRIDGE",
            "state": "MI",
            "postal_code": "480455266",
            "telephone_number": "586-239-3005",
            "fax_number": "586-239-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USCG DETROIT PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_title_or_position": "CHIEF DHA PASS",
        "authorized_official_telephone_number": "210-536-6650"
    },
    "taxonomies": [
        {
            "code": "332000000X",
            "taxonomy_group": "",
            "desc": "Military/U.S. Coast Guard Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USCG DETROIT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ian W Munger, IDHS

• Military/U.S. Coast Guard Pharmacy in Selfridge, MI
• Providers in Selfridge, MI by specialty
• Military/U.S. Coast Guard Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.