KOACH3 INC (NPI# 1306164140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306164140 |
| Entity Type | Organization |
| Organization Name | KOACH3 INC |
| Other Organization Name | PRESTIGE PHARMACY |
| Practice Address |
9600 Dexter Ave Detroit MI 48206-1816 |
| Practice Telephone | 3138709201 |
| Practice Fax Number | 3138709207 |
| Mailing Telephone | 3138709201 |
| Mailing Fax Number | 3138709207 |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2011-06-14 |
| Authorized Official Name | KOMAL ACHARYA (PRESIDENT) |
| Authorized Official Telephone | 3138709201 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301009312 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 2374039 | 01 |
| Other Name | Type Code |
|---|---|
| Prestige Pharmacy | Doing Business As Name - Organization |
| Street Address |
9600 DEXTER AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48206-1816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235196023 | Angela Lynn Roman | Nurse Practitioner | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2006-04-27 |
| 1295118842 | Preventative Patterns Care Management | Early Intervention Provider Agency | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2015-07-01 |
| 1497172381 | Light of Hope Family Medical Clinic | Clinic/Center | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2014-03-28 |
| 1770911703 | Romancare Health Services | Nurse Practitioner | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2013-10-30 |
| 1538504626 | Northwest Surgical & Medical Comprehensive Services PC | General Practice | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2013-05-03 |
| 1518238104 | Taylor Comprehensive Care | Family Medicine | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2012-01-13 |
| 1144507682 | Ayhanna Latoya Dennis | Counselor | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2011-11-11 |
| 1730481201 | Dennis Irvine | Counselor | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2010-12-03 |
| 1275833709 | Northwest Industrail Drug Rehabilitation Clinic | Counselor | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2010-11-01 |
| 1679873798 | Northwest Drug Rehabilitation Inc | Clinic/Center | 9600 Dexter Ave, Detroit, MI 48206-1816 | 2010-10-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861962094 | Reid Talley | Counselor | 12010 Elmhurst, Detroit, MI 48206 | 2018-11-30 |
| 1306330246 | Harper's Care Club, LLC | Home Health | 1732 W Bethune St Apt 4, Detroit, MI 48206 | 2018-06-14 |
| 1700210440 | Tender Loving Care Assisted Living | Custodial Care Facility | 2250 W.euclid, Detroit, MI 48206 | 2013-08-29 |
| 1063560761 | Platinum Care Pharmacy Inc. | Pharmacy | 8500 14th Street, Detroit, MI 48206 | 2007-01-08 |
| 1619067527 | Young-sims Clinic PC | Family Medicine | 9150 Linwood, Detroit, MI 48206 | 2006-10-13 |
| 1093811200 | Grace W Patterson | Family Medicine | 9150 Linwood Ave, Detroit, MI 48206 | 2006-09-15 |
| 1164437992 | Rosa Park Medical Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8665 Rosa Parks Boulavard, Detroit, MI 48206 | 2006-07-30 |
| 1336495696 | Ephraim I Onwuegbuchu | Pharmacist | 8500 14th Street, Detroit, MI 48206 | 2012-07-24 |
| 1962647552 | Jabez Recovery Management Services, Inc | Substance Abuse Rehabilitation Facility | 2755 Collingwood St, Detroit, MI 48206 | 2008-12-10 |
| 1033215918 | Robert Nmn Sims | Family Medicine | 9150 Linwood Ave, Detroit, MI 48206 | 2006-09-16 |
| Find all providers in zip 48206 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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: new] |
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| 1114556859 | Buena Salud LLC | Pharmacy | 7607 W Vernor Hwy, Detroit, MI 48209-1513 | 2020-04-04 |
| 1932737210 | West Park Pharmacy LLC | Pharmacy | 16240 W Warren Ave, Detroit, MI 48228 | 2020-03-31 |
| 1952938516 | Sinai Medical Pharmacy, LLC | Pharmacy | 16841 Schaefer Hwy, Detroit, MI 48235-4271 | 2020-03-24 |
| 1881231991 | Six Mile Medical Pharmacy, LLC | Pharmacy | 10420 W Mcnichols Rd Ste A, Detroit, MI 48221-2356 | 2019-12-08 |
| 1215570791 | Goshen Pharmacy LLC | Pharmacy | 16800 Greenfield Rd Unit B2, Detroit, MI 48235-3703 | 2019-10-28 |
| Find all providers in DETROIT | ||||
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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.