HEALTHCENTER PHARMACY, LLC (NPI# 1104397843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104397843 |
| Entity Type | Organization |
| Organization Name | HEALTHCENTER PHARMACY, LLC |
| Other Organization Name | HEALTHCENTER PHARMACY |
| Practice Address |
21600 Harper Ave Ste 300 Saint Clair Shores MI 48080-2242 |
| Mailing Address |
45711 Samantha Dr Canton MI 48188-2190 |
| Practice Telephone | 5864214003 |
| Practice Fax Number | 5864214654 |
| Mailing Telephone | 3134430096 |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2020-05-18 |
| Authorized Official Name | DR. MUSTAFA M HAIDAR (PHARMACIST/PIC) |
| Authorized Official Telephone | 5864214003 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MICHIGAN STATE LICENSE | 5301011513 | 01 |
| Other Name | Type Code |
|---|---|
| HealthCenter Pharmacy | Doing Business As Name - Organization |
| Street Address |
21600 HARPER AVE STE 300 |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48080-2242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508482084 | Farrah Aleema Rajab | Family Medicine | 24911 Little Mack Avenue, Suite C, St. Clair Shores, MI 48080 | 2020-06-22 |
| 1558986141 | Julia Anastazja Krakowska | Family Medicine | 24911 Little Mack, Suite C, St. Clair Shores, MI 48080 | 2020-06-10 |
| 1972073567 | Joyce Stepnak | Social Worker | 19611 E. 8 Mile Rd, Scs, MI 48080 | 2018-11-27 |
| 1487134177 | Bonnie Girson | Social Worker | 23409 Jefferson Ave Ste 100, Saint Clair Shores, MI 48080 | 2018-08-21 |
| 1609309913 | Park Pharmacy Scs LLC | Pharmacy | 20225 E 9 Mile Rd Ste 120a, Saint Clair Shores, MI 48080 | 2017-04-05 |
| 1730564055 | Mary Rose Giroux | Psychologist | 22516 Overlake St, St. Clair Shores, MI 48080 | 2015-07-28 |
| 1962882910 | Ali Tarif Bazzy | Family Medicine | 20225 E 9 Mile Rd Ste A, Saint Clair Shores, MI 48080 | 2015-06-04 |
| 1497156228 | Kelly Zalewski | Social Worker | 24631 Jefferson Ave, Saint Clair Shores, MI 48080 | 2014-09-11 |
| 1669871364 | Mallory Margret Gordon | Psychologist | 19900 E. 10 Mile Rd., Ste. 102, Saint Clair Shores, MI 48080 | 2014-08-19 |
| 1932549375 | Alexander Peter Bill | Otolaryngology | 22631 Greater Mack Ave Ste 200, Saint Clair Shores, MI 48080 | 2013-06-30 |
| Find all providers in zip 48080 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609309913 | Park Pharmacy Scs LLC | Pharmacy | 20225 E 9 Mile Rd Ste 120a, Saint Clair Shores, MI 48080 | 2017-04-05 |
| 1558781666 | Shores Specialty Pharmacy LLC | Pharmacy | 29306 Harper Ave, Saint Clair Shores, MI 48081-2712 | 2014-04-16 |
| 1013932672 | Bormans Inc | Pharmacy | 22332 E 9 Mile Rd, Saint Clair Shores, MI 48080-1972 | 2006-07-13 |
| 1972824126 | St Clair Pharmacy LLC | Pharmacy | 28001 Harper Ave, Saint Clair Shores, MI 48081-1561 | 2010-06-22 |
| 1265526669 | Henry Ford Health System | Pharmacy | 24725 Jefferson Ave, Saint Clair Shores, MI 48080-4500 | 2006-10-03 |
| 1710918792 | Kmart Operations LLC | Pharmacy | 22801 Harper Ave, Saint Clair Shores, MI 48080-1848 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961763 | Dustyn Daniel Thoney | Pharmacy | 530 Harding Ave, Iron River, MI 49935-2265 | 2020-10-27 |
| 1497355697 | Katherine Jane Cybulski | Pharmacy | 1310 Waukazoo St, Hastings, MI 49058-9559 | 2020-10-27 |
| 1043836042 | Hanan Pharmacy LLC | Pharmacy | 4600 E 14 Mile Road, Suite 2, Warren, MI 48092-1057 | 2020-06-25 |
| 1770104192 | Hazelwood Pharmacy LLC | Pharmacy | 624 E 9 Mile Rd Ste C, Hazel Park, MI 48030-1842 | 2020-04-27 |
| 1457980609 | Berkley Pharmacy LLC | Pharmacy | 28577 Schoenherr Road, Warren, MI 48088 | 2020-04-08 |
| 1669012316 | Warriors Pharmacy, Inc. | Pharmacy | 5265 Anthony Wayne Dr, Detroit, MI 48202-3947 | 2020-01-10 |
| 1457996662 | Sunrise Pharmacy, LLC | Pharmacy | 989 University Dr Ste 104, Pontiac, MI 48342-1885 | 2019-11-12 |
| 1447894019 | Nova Pharmacy | Pharmacy | 15140 Levan Rd, Suite 40, Livonia, MI 48154 | 2019-11-06 |
| 1912541673 | Wayne Pharma | Pharmacy | 974 Ford Ave, Wyandotte, MI 48192 | 2019-11-05 |
| 1639720667 | Grand Haven Pharmacy LLC | Pharmacy | 930 John R Rd Ste Pharmacy, Troy, MI 48083-4316 | 2019-09-20 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48080 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.