TONY KOEHN (NPI# 1457833303) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457833303 |
| Entity Type | Individual |
| Full Name | TONY KOEHN |
| Practice Address |
3990 John R St Detroit MI 48201-2018 |
| Mailing Address |
1418 Cobblestone Ct Ann Arbor MI 48108-9553 |
| Practice Telephone | 3137458395 |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2018-09-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | RPH-0015652 | OR | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 5302041464 | MI | Pharmacy Service Providers |
| Street Address |
3990 JOHN R ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619959707 | Candice Garwood | Pharmacist | 3990 John R St, Department of Pharmacy, Detroit, MI 48201-2018 | 2005-11-15 |
| 1396342085 | Tzu-bou Hsieh | Obstetrics & Gynecology | 3990 John R St, Detroit, MI 48201-2018 | 2020-10-06 |
| 1558976928 | Ashley Mary Asmar | Nurse Practitioner | 3990 John R St, Detroit, MI 48201-2018 | 2020-09-12 |
| 1871102574 | Adam Ryan Mills | Registered Nurse | 3990 John R St, Detroit, MI 48201-2018 | 2020-07-28 |
| 1033734082 | Sean Lang | Pharmacist | 3990 John R St, Detroit, MI 48201-2018 | 2020-06-15 |
| 1568084259 | Carly Victoria Burns | Pharmacist | 3990 John R St, Detroit, MI 48201-2018 | 2020-05-15 |
| 1154941805 | Dustin David Reykdal | Student in an Organized Health Care Education/Training Program | 3990 John R St, Detroit, MI 48201-2018 | 2020-04-23 |
| 1902426513 | Merva N. Gilani | Student in an Organized Health Care Education/Training Program | 3990 John R St, Detroit, MI 48201-2018 | 2020-04-23 |
| 1659991271 | Elisabeth Lederman Wong | Student in an Organized Health Care Education/Training Program | 3990 John R St, Detroit, MI 48201-2018 | 2020-04-23 |
| 1366080640 | Joel David Ziettlow | Nurse Anesthetist, Certified Registered | 3990 John R St, Detroit, MI 48201-2018 | 2019-12-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366073926 | Peter Shaouni | Pharmacist | 15521 W 7 Mile Rd, Detroit, MI 48235-2927 | 2020-01-31 |
| 1598396285 | Mehak Siddiqui | Pharmacist | 200 Renaissance Ctr, Detroit, MI 48243-1300 | 2020-01-31 |
| 1073143384 | Marco Santos | Pharmacist | 6862 Michigan Ave, Detroit, MI 48210-2868 | 2020-01-26 |
| 1841774528 | Belief Aghoghome Emadamerho | Pharmacist | 13641 East 7 Mile Rd, Detroit, MI 48205 | 2018-09-19 |
| 1376025262 | Maeghan Hensler | Pharmacist | 7800 Outer Dr., Detroit, MI 48235 | 2018-09-06 |
| 1417445719 | Wagdi Abdulla | Pharmacist | 14424 Schaefer Hwy, Detroit, MI 48227-3668 | 2018-04-23 |
| 1528579331 | Mahmoud Srour | Pharmacist | 4100 Woodward Ave Ste Pharmacy, Detroit, MI 48201-2173 | 2017-10-19 |
| 1477073039 | Emalee M Osentoski | Pharmacist | 4100 John R St Ste Hp00sp, Detroit, MI 48201-2013 | 2017-06-26 |
| 1144755588 | Eric Foster | Pharmacist | 11574 Roxbury St, Detroit, MI 48224-1141 | 2017-04-24 |
| 1013440460 | Maqsood Ahmad | Pharmacist | 12170 Conant St Ste E, Detroit, MI 48212-4129 | 2017-04-04 |
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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.