NPIMap

Organization Active NPI

Southeast Michigan Surgical Hospital, LLC

  • Pharmacy
  • Warren, MI
National Provider Identifier
1942942511
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
SOUTHEAST MICHIGAN SURGICAL HOSPITAL, LLC
Practice address
21230 Dequindre Rd
Warren, MI 48091-2279
Phone
(810) 275-9333
NPI assigned
Apr 12, 2022
Last updated
Apr 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Authorized official

Name
Mohammad Nadir Ijaz
Title
Coo
Phone
(810) 275-9371

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

21230 Dequindre Rd
Warren, MI 48091-2279

Mailing address

21230 Dequindre Rd
Warren, MI 48091-2279
Phone (810) 275-9333

Other names 1

  • Insight Outpatient Pharmacy Other name

National Provider Directory

National Provider Directory
Tax ID family
Southeast Michigan Surgical6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1942942511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21230 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480912279",
            "telephone_number": "810-275-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21230 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480912279",
            "telephone_number": "810-275-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST MICHIGAN SURGICAL HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "IJAZ",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "NADIR",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "810-275-9371"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Insight Outpatient Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.