Active NPI
Mansoor Khan, PHARM. D.
- Pharmacist
- Chesterfield, MI
National Provider Identifier
1992090559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302038025
- Practice address
- 51400 Gratiot Ave
T-0945
Chesterfield, MI 48051-2007 - Phone
- (586) 598-4770
- Fax
- (586) 598-4770
- NPI assigned
- Jun 12, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302038025 | MI | Primary |
Addresses
Primary practice location
51400 Gratiot Ave
T-0945
Chesterfield, MI 48051-2007
Mailing address
51400 Gratiot Ave
T-0945
Chesterfield, MI 48051-2007
Phone (586) 598-4770
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302038025 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pontiac General Hospital Pharmacy Inc. | Current | Accepting new patients | |
| Pontiac General Hospital Pharmacy Inc. | Current | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Pontiac, MI
- NPI 1568954014
-
- Institutional Pharmacy
- Pontiac, MI
- NPI 1609461912
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307836800000",
"number": "1992090559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51400 GRATIOT AVE",
"address_2": "T-0945",
"city": "CHESTERFIELD",
"state": "MI",
"postal_code": "480512007",
"telephone_number": "586-598-4770",
"fax_number": "586-598-4770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51400 GRATIOT AVE",
"address_2": "T-0945",
"city": "CHESTERFIELD",
"state": "MI",
"postal_code": "480512007",
"telephone_number": "586-598-4770",
"fax_number": "586-598-4770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "MANSOOR",
"credential": "PHARM. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-12",
"last_updated": "2011-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302038025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesterfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.