Individual provider Active NPI

Mohamad Hussain, PHARMD

  • Pharmacist
  • Eastpointe, MI
National Provider Identifier
1992129084
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302041712 Issued in MI
Practice address
22640 Kelly Rd
Eastpointe, MI 48021-2624
Phone
(586) 533-2835
NPI assigned
Feb 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302041712 MI Primary

Addresses

Primary practice location

22640 Kelly Rd
Eastpointe, MI 48021-2624

Mailing address

7916 Orchard Ave
Dearborn, MI 48126-1070
Phone (313) 622-3046

Other practice location 1

2971 W Maple Rd
Troy, MI 48084-7032
Phone (248) 288-4385

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

LicenseStateTypeSpecialty
5302041712MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Eastpointe Medical Pharmacy LLC CurrentSince Apr 20, 2021 Accepting new patients
Perry Drug Stores Inc and Subsidiaries Past Accepting new patients
Perry Drug Stores Inc and Subsidiaries Past Accepting new patients

Locations

22640 Kelly Rd
Eastpointe, MI 48021
Phone (586) 533-2835

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1992129084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7916 ORCHARD AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261070",
            "telephone_number": "313-622-3046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22640 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480212624",
            "telephone_number": "586-533-2835"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2971 W Maple Rd",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480847032",
            "country_code": "US",
            "telephone_number": "248-288-4385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "MOHAMAD",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-10",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302041712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastpointe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.