Active NPI
Holiday Pharmacy PLLC
- Community/Retail Pharmacy
- Sterling Heights, MI
National Provider Identifier
1952380065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 5301003121
- Legal business name
- HOLIDAY PHARMACY PLLC
- Doing business as
- Holiday Pharmacy PLLC
- Practice address
- 37771 Schoenherr Rd
Sterling Heights, MI 48312-2302 - Phone
- (586) 274-4332
- Fax
- (586) 274-4828
- NPI assigned
- Jan 17, 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
- R Melody Shanbaum
- Title
- Ceo/Owner
- Phone
- (248) 546-5500
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 5301003121 | MI | Primary |
Addresses
Primary practice location
37771 Schoenherr Rd
Sterling Heights, MI 48312-2302
Mailing address
6443 Inkster Rd
Ste 170F
Bloomfield Hills, MI 48301-1318
Phone (586) 274-4332
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2318598 | Medicaid | MI | |
| 2040962 | Other | PK | |
| 4845265 | Medicaid | MI |
Other names 1
- HOLIDAY PHARMACY PLLC
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1615507200000",
"number": "1952380065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6443 INKSTER RD",
"address_2": "STE 170F",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483011318",
"telephone_number": "586-274-4332",
"fax_number": "586-274-4828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37771 SCHOENHERR RD",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483122302",
"telephone_number": "586-274-4332",
"fax_number": "586-274-4828"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLIDAY PHARMACY PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-01-17",
"last_updated": "2021-03-12",
"certification_date": "2021-03-12",
"status": "A",
"authorized_official_last_name": "SHANBAUM",
"authorized_official_first_name": "R",
"authorized_official_middle_name": "MELODY",
"authorized_official_title_or_position": "CEO/OWNER",
"authorized_official_telephone_number": "248-546-5500"
},
"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": "5301003121",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2318598",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2040962",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4845265",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "HOLIDAY PHARMACY PLLC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "HOLIDAY PHARMACY PLLC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Sterling Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.