Hassan Mohamad Kraidi

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

5302042979 Issued in MI

Practice address

122 S Main St
Eaton Rapids, MI 48827-1068

Phone

(517) 663-6811

Fax

(517) 663-1732

NPI assigned

May 8, 2019

Last updated

May 8, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Pharmacy- Eaton Rapids, LLC

  • Long Term Care Pharmacy
  • Eaton Rapids, MI
  • NPI 1508610601
  NPD Authorized official
• Vivarx LLC

  • Community/Retail Pharmacy
  • Dearborn Heights, MI
  • NPI 1982536694
  NPD Authorized official
• Central Pharmacy- Eaton Rapids, LLC

  dba Rottenbucher Pharmacy

  • Community/Retail Pharmacy
  • Eaton Rapids, MI
  • NPI 1295875284
  NPD

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1952966525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 S MAIN ST",
            "city": "EATON RAPIDS",
            "state": "MI",
            "postal_code": "488271068",
            "telephone_number": "517-663-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S MAIN ST",
            "city": "EATON RAPIDS",
            "state": "MI",
            "postal_code": "488271068",
            "telephone_number": "517-663-6811",
            "fax_number": "517-663-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAIDI",
        "first_name": "HASSAN",
        "middle_name": "MOHAMAD",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-08",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MI",
            "license": "5302042979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jpspine LLC
• Julie Reincke Counselor PLLC
• Drew Kapture, DPT
• Thomas Alan Kelly, D.O.
• Anne Cameron Khol, N.D., F.N.P., B.C.
• Hyuck S Kwon, RPH
• Chet Lafave, OTRL
• Anne Lange, BSN, LMSW, ACSW
• Laura Jo Launstein, OTR
• Lazaro Transitions MHT LLC

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Eaton Rapids, MI
• Providers in Eaton Rapids, MI by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; 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.