Diversified Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301007150 Issued in MI

Legal business name

DIVERSIFIED PHARMACY INC

Doing business as

Medivera Compounding Pharmacy

Practice address

5225 Crooks Rd
Troy, MI 48098-2823

Phone

(248) 267-5002

Fax

(248) 267-5003

NPI assigned

Aug 27, 2006

Last updated

Sep 30, 2025By 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

Dr. Bradley McCloskey, PHARMDNPI 1356490494

Title

Pharmacist in Charge

Phone

(248) 267-5002

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Medivera Compounding Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley McCloskey, PHARMD

  • Pharmacist
  • Troy, MI
  • NPI 1356490494
  NPD Authorized official

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759190400000",
    "number": "1982712352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 CROOKS RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480982823",
            "telephone_number": "248-267-5002",
            "fax_number": "248-267-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 CROOKS RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480982823",
            "telephone_number": "248-267-5002",
            "fax_number": "248-267-5003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A",
        "authorized_official_last_name": "MCCLOSKEY",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "248-267-5002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301007150",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2360701",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP #",
            "identifier": "2360701",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2360701",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medivera Compounding Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Troy, MI
• Providers in Troy, 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 Sep 30, 2025; 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.