NPIMap

Organization Active NPI

Van Buren Pharmacy LLC

Doing business as Van Buren Pharmacy

  • Community/Retail Pharmacy
  • Belleville, MI
National Provider Identifier
1982922779
Registry record updated Nov 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301010196 Issued in MI
Legal business name
VAN BUREN PHARMACY LLC
Doing business as
Van Buren Pharmacy
Practice address
11650 Belleville Rd
Suite 103
Belleville, MI 48111-3380
Phone
(734) 325-6318
Fax
(734) 325-1007
NPI assigned
May 4, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2013

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

Authorized official

Name
Sameerah Cortez, RPHNPI 1578057683
Title
P.I.C.
Phone
(734) 325-6318

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301010196 MI Primary

Addresses

Primary practice location

11650 Belleville Rd
Suite 103
Belleville, MI 48111-3380

Mailing address

11650 Belleville Rd
Suite 103
Belleville, MI 48111-3380
Phone (734) 325-6318

Other identifiers 2

IdentifierTypeStateIssuer
1982922779MedicaidMI
2125315OtherPK

Other names 1

  • Van Buren Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

11650 Belleville Rd
Ste 103
Van Buren Township, MI 48111
Phone (734) 325-6318

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1982922779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11650 BELLEVILLE RD",
            "address_2": "SUITE 103",
            "city": "BELLEVILLE",
            "state": "MI",
            "postal_code": "481113380",
            "telephone_number": "734-325-6318",
            "fax_number": "734-325-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11650 BELLEVILLE RD",
            "address_2": "SUITE 103",
            "city": "BELLEVILLE",
            "state": "MI",
            "postal_code": "481113380",
            "telephone_number": "734-325-6318",
            "fax_number": "734-325-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN BUREN PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-04",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "CORTEZ",
        "authorized_official_first_name": "SAMEERAH",
        "authorized_official_title_or_position": "P.I.C.",
        "authorized_official_telephone_number": "734-325-6318",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982922779",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2125315",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Van Buren Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belleville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.