Highland Park Glory Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010044 Issued in MI

Legal business name

HIGHLAND PARK GLORY PHARMACY LLC

Doing business as

Pharmor Pharmacy- Highland Park

Practice address

23815 Northwestern Hwy Ste 120
Southfield, MI 48075-7738

Phone

(248) 996-8441

Fax

(248) 996-8827

NPI assigned

Jul 10, 2013

Organization subpart

No

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

Authorized official

Name

Mohamed Sohoubah

Title

Owner

Phone

(248) 663-3380

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• PHARMOR PHARMACY- HIGHLAND PARK Doing business as

Locations

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476230400000",
    "number": "1821439621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23815 NORTHWESTERN HWY",
            "address_2": "SUITE 120",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480757738",
            "telephone_number": "248-996-8441",
            "fax_number": "248-996-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23815 NORTHWESTERN HWY STE 120",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480757738",
            "telephone_number": "248-996-8441",
            "fax_number": "248-996-8827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND PARK GLORY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-10",
        "last_updated": "2016-10-12",
        "status": "A",
        "authorized_official_last_name": "SOHOUBAH",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-663-3380"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821439621",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2141090",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMOR PHARMACY- HIGHLAND PARK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Larry Hicks
• Courtney Christine Hige, PA-C
• William Higginbotham III, MD
• Tiki Higgins-Todd, LMSW
• High Hope Home Care (H3) L.L.C
• Daisha Hill, LMSW
• Kaitlyn Patricia Hill
• Kasaundra Hill
• Kerri Hill
• Khalia Hill

• Community/Retail Pharmacy in Southfield, MI
• Providers in Southfield, 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 Oct 12, 2016; 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.