Gbogbara Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301006276 Issued in MI

Legal business name

GBOGBARA INC

Practice address

12871 E Jefferson
Detroit, MI 48215-2754

Phone

(313) 331-8484

Fax

(313) 331-1864

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Lenyie N Ngbogbara

Title

President

Phone

(313) 331-8484

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• King Pharmacy Other name

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Gbogbara Inc

  dba King Pharmacy

  • Community/Retail Pharmacy
  • Roseville, MI
  • NPI 1063860484
  NPPES parent name
• Gbogbara Inc

  dba King Pharmacy

  • Community/Retail Pharmacy
  • Detroit, MI
  • NPI 1609471135
  NPPES parent name

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1982715447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12871 E JEFFERSON",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152754",
            "telephone_number": "313-331-8484",
            "fax_number": "313-331-1864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12871 E JEFFERSON",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152754",
            "telephone_number": "313-331-8484",
            "fax_number": "313-331-1864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GBOGBARA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "NGBOGBARA",
        "authorized_official_first_name": "LENYIE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-331-8484",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301006276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3155302",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "King Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Beverly Ann Gayles, LPN
• Kawana Gaynor
• Roland E Gazaille III, D.O.
• Edward Gazaryan
• Gbogbara Inc (King Pharmacy)
• Erin Ge, M.D.
• Gabrielle Gear
• Benjamin K Gearhart, CRNA
• Elizabeth Ann Gebeck, CRNA
• Samar Geblawi

• Community/Retail Pharmacy in Detroit, MI
• Providers in Detroit, 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 Dec 9, 2020; 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.