Ryan Kallabat, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302416955 Issued in MI

Practice address

6070 W Maple Rd
West Bloomfield, MI 48322-2212

Phone

(248) 865-2290

Fax

(248) 865-1193

NPI assigned

Oct 31, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Woodward Detroit CVS, L.L.C.

  • Pharmacy
  • West Bloomfield, MI
  • NPI 1649379942
  NPD (past)

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1801619648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6070 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222212",
            "telephone_number": "248-865-2290",
            "fax_number": "248-865-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6070 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222212",
            "telephone_number": "248-865-2290",
            "fax_number": "248-865-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLABAT",
        "first_name": "RYAN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302416955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Kakos, MSW
• Rebekah Lynn Kakos
• Maria A Kalasho, P.A.-C
• Udday Kihidir Kalasho, PHARMD
• Ghadda Kallabat
• Margaret Ann Kamenec, PT
• Lisa Kane, DDS
• Pamela Kane, OT
• Kansas Telemedicine Associates PC
• Kap Case Management

• Pharmacist in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.