Dearborn RX Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010958 Issued in MI

Legal business name

DEARBORN RX PHARMACY LLC

Doing business as

Dearborn RX Pharmacy

Practice address

10633 W Warren Ave Ste a
Dearborn, MI 48126-8010

Phone

(313) 633-0683

Fax

(313) 438-0150

NPI assigned

Jun 16, 2016

Last updated

Nov 8, 2016By 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

Ketan Saggar

Title

HD of Phcy Ops, Phcy MGR, Pic, Ao

Phone

(313) 655-6052

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• DEARBORN RX PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1982054383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10633 W WARREN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481268010",
            "telephone_number": "313-633-0683",
            "fax_number": "313-438-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10633 W WARREN AVE STE A",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481268010",
            "telephone_number": "313-633-0683",
            "fax_number": "313-438-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEARBORN RX PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "SAGGAR",
        "authorized_official_first_name": "KETAN",
        "authorized_official_title_or_position": "HD OF PHCY OPS, PHCY MGR, PIC, AO",
        "authorized_official_telephone_number": "313-655-6052"
    },
    "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": "5301010958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2160572",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEARBORN RX PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Dearborn, MI
• Providers in Dearborn, 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 8, 2016; 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.