Mirna Massod-Luca

Primary specialty

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

License

5302413661 Issued in MI

Practice address

23191 Marter Rd
Saint Clair Shores, MI 48080-2717

Phone

(586) 541-1370

NPI assigned

May 12, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Kroger Co of Michigan

  • Community/Retail Pharmacy
  • Harper Woods, MI
  • NPI 1306870175
  NPD (past)
• Kroger Co of Michigan

  • Community/Retail Pharmacy
  • Fenton, MI
  • NPI 1326917394
  NPD (past)
• Kroger Co of Michigan

  • Community/Retail Pharmacy
  • Saint Clair Shores, MI
  • NPI 1942434287
  NPD (past)

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1982340824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20903 HARPER AVE",
            "city": "HARPER WOODS",
            "state": "MI",
            "postal_code": "482251132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23191 MARTER RD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480802717",
            "telephone_number": "586-541-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASSOD-LUCA",
        "first_name": "MIRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302413661",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "MI",
            "license": "5302413661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Martinovski, NP
• Mary Arnone Epoch Holistic Massage
• Sharon Kay Masek, LMSW
• Robert C Masi, DDS
• Alexandra Mason, LPC
• Linas Victor Mastis, M.D.
• Raminta Mastis, D.D.S.
• Mark Peter Mastromonaco, MD
• Neethu Mathew, M.D.
• Alma Maurer

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, 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 Nov 30, 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.