Active NPI
Independent Community Pharmacy Inc
- Clinic Pharmacy
- Dearborn, MI
National Provider Identifier
1801991757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic Pharmacy
- Legal business name
- INDEPENDENT COMMUNITY PHARMACY INC
- Doing business as
- INDEPENDENT COMMUNITY PHCY
- Practice address
- 8742 W Warren
Dearborn, MI 48126 - Phone
- (313) 931-2133
- Fax
- (313) 931-3509
- NPI assigned
- Sep 14, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Victor Koblin, RPH
- Title
- President
- Phone
- (318) 931-2133
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 5301003741 | MI | |
| Clinic Pharmacy | 3336C0002X | Primary | ||
| Community/Retail Pharmacy | 3336C0003X |
Addresses
Primary practice location
8742 W Warren
Dearborn, MI 48126
Mailing address
8742 W Warren
Dearborn, MI 48126
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2541233 | Medicaid | MI | |
| 2333007 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- INDEPENDENT COMMUNITY PHCY
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1801991757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8742 W WARREN",
"city": "DEARBORN",
"state": "MI",
"postal_code": "48126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8742 W WARREN",
"city": "DEARBORN",
"state": "MI",
"postal_code": "48126",
"telephone_number": "313-931-2133",
"fax_number": "313-931-3509"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INDEPENDENT COMMUNITY PHARMACY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-14",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "KOBLIN",
"authorized_official_first_name": "VICTOR",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "318-931-2133",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "MI",
"license": "5301003741",
"primary": false
},
{
"code": "3336C0002X",
"taxonomy_group": "",
"desc": "Pharmacy, Clinic Pharmacy",
"state": null,
"license": null,
"primary": true
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2541233",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "2333007",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "INDEPENDENT COMMUNITY PHCY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.