Sea Rex LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SEA REX LLC

Practice address

5770 Plymouth Rd
Ann Arbor, MI 48105-9312

Phone

(734) 214-1234

NPI assigned

Nov 8, 2020

Organization subpart

No

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

Authorized official

Name

Candi Tolf

Title

3Rd Party Coordinator

Phone

(734) 214-1234

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rexall Ann Arbor Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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

{
    "created_epoch": "1604793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1982205654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 ORCHARD LAKE RD STE 180-183",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483231604",
            "telephone_number": "248-963-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 PLYMOUTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059312",
            "telephone_number": "734-214-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA REX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-08",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "TOLF",
        "authorized_official_first_name": "CANDI",
        "authorized_official_title_or_position": "3RD PARTY COORDINATOR",
        "authorized_official_telephone_number": "734-214-1234"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLEXSCRIPT",
            "identifier": "FSRX2846318",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rexall Ann Arbor Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rexall Ann Arbor Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zamya Lenise Scott
• Lynne Connor Scoville, MSW
• Caitlin Scroggins, MSN, AGACNP-BC
• Elizabeth Anne Scruggs-Wodkowski, MD
• Courtney Marie Scruggs, CRNA
• Andrew Seaford
• Katharine Surella Seagly, PHD
• Loo Gen Seah McCrea, LPC, NCC
• Aimee Seaman, NP
• Courtney Alexis Seaman, MSOT/OTRL/CCTP

• Community/Retail Pharmacy in Ann Arbor, MI
• Providers in Ann Arbor, 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 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.