Six Mile Medical Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SIX MILE MEDICAL PHARMACY, LLC

Doing business as

Pharmor Pharmacy - Six Mile

Practice address

10420 W McNichols Rd Ste a
Detroit, MI 48221-2356

Phone

(313) 635-2788

Fax

(313) 635-2789

NPI assigned

Dec 8, 2019

Last updated

Nov 4, 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

Hamdan Alyaeishi, RPHNPI 1659902369

Title

Pharmacy Owner

Phone

(313) 635-2788

Specialties & licenses 1

Addresses

Other names 1

• PHARMOR PHARMACY - SIX MILE Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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.

• Hamdan Alyaeishi, PHARMD

  • Pharmacist
  • Detroit, MI
  • NPI 1659902369
  NPD Authorized official

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

{
    "created_epoch": "1575763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635984000000",
    "number": "1881231991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10420 W MCNICHOLS RD STE A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10420 W MCNICHOLS RD STE A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212356",
            "telephone_number": "313-635-2788",
            "fax_number": "313-635-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIX MILE MEDICAL PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-08",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A",
        "authorized_official_last_name": "ALYAEISHI",
        "authorized_official_first_name": "HAMDAN",
        "authorized_official_title_or_position": "PHARMACY OWNER",
        "authorized_official_telephone_number": "313-635-2788",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHARMOR PHARMACY - SIX MILE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHARMOR PHARMACY - SIX MILE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Peter Sisung
• Natraj Sitaram, MD
• Jerome Sitner, D.O.
• Srividhya Sivanandan
• Mohana Sivasankaran, PHARMACY TECHNICIAN
• Six Mile Medical, PLLC
• Six Mile Pharmacy LLC (Six Mile Pharmacy)
• SK Counseling and Consultation
• Amelia Marie Skaleski, CNP
• Annette M. Skalski, RN

• Community/Retail Pharmacy in Detroit, MI
• Providers in Detroit, 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 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.