Knight Drugs West Warren, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

5301006711 Issued in MI

Legal business name

KNIGHT DRUGS WEST WARREN, INC.

Practice address

1131 W Warren Ave
Detroit, MI 48201-3601

Phone

(313) 832-6091

Fax

(313) 832-6746

NPI assigned

Aug 26, 2005

Organization subpart

No

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

Authorized official

Name

Mr. John Dejongh

Title

President of Operations

Phone

(248) 540-8066

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Knight Drugs West Warren Doing business as

Locations

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243555200000",
    "number": "1982697710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 INDUSTRIAL ROW DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480847035",
            "telephone_number": "248-540-8066",
            "fax_number": "248-540-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482013601",
            "telephone_number": "313-832-6091",
            "fax_number": "313-832-6746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KNIGHT DRUGS WEST WARREN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2009-05-29",
        "status": "A",
        "authorized_official_last_name": "DEJONGH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "248-540-8066",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301006711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1982697710",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2357754",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3421098",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Knight Drugs West Warren",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Aziza Knight, DC

• Pharmacy in Detroit, MI
• Providers in Detroit, MI by specialty
• Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2009; 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.