Highland Park Oak Street Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

HIGHLAND PARK OAK STREET PHARMACY, LLC

Practice address

14529 Woodward Ave
Highland Park, MI 48203-2905

Phone

(313) 485-2971

NPI assigned

Jul 8, 2020

Organization subpart

Yes

Parent organization

HIGHLAND PARK OAK STREET PHARMACY, LLCAs reported in NPPES

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

Authorized official

Name

Fouad Omar, PHARM.D.

Title

Pharmacist

Phone

(313) 485-2971

Specialties & licenses 1

Addresses

Other names 2

• PharMor Pharmacy- Oak Street Clinic Doing business as
• PharMor Pharmacy-Highland Park Place Doing business as

Part of

Highland Park Oak Street Pharmacy LLC

Locations

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597363200000",
    "number": "1891313755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14529 WOODWARD AVE",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482032905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14529 WOODWARD AVE",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482032905",
            "telephone_number": "313-485-2971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND PARK OAK STREET PHARMACY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HIGHLAND PARK OAK STREET PHARMACY, LLC",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A",
        "authorized_official_last_name": "OMAR",
        "authorized_official_first_name": "FOUAD",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "313-485-2971",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PharMor Pharmacy- Oak Street Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PharMor Pharmacy-Highland Park Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Wendy Marcella Hershey, FAODP
• Highland Park Medical Center, PLLC
• Highland Park Opco, LLC
• Kim C Hood, FAODP
• Audrey Rose Hooke, R.N
• Sammiyah S Hoskin
• Kemit Hoye

• Community/Retail Pharmacy in Highland Park, MI
• Providers in Highland Park, 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 Aug 14, 2020; 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.