PARK PHARMACY SCS LLC (NPI# 1609309913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609309913 |
| Entity Type | Organization |
| Organization Name | PARK PHARMACY SCS LLC |
| Other Organization Name | PARK PHARMACY SCS |
| Practice Address |
20225 E 9 Mile Rd Ste 120a Saint Clair Shores MI 48080 |
| Mailing Address |
20225 E 9 Mile Rd Ste 120a Saint Clair Shores MI 48080-1700 |
| Practice Telephone | 5864475189 |
| Practice Fax Number | 5867747187 |
| Mailing Telephone | 5864475189 |
| Mailing Fax Number | 5867747187 |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2018-11-08 |
| Authorized Official Name | NASSAR BEYDOUN (OWNER) |
| Authorized Official Telephone | 3139998560 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301011114 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2170711 | 01 |
| Other Name | Type Code |
|---|---|
| PARK PHARMACY SCS | Doing Business As Name - Organization |
| Street Address |
20225 E 9 MILE RD STE 120A |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811462849 | Nassar Beydoun | Pharmacist | 20225 E 9 Mile Rd Ste 120a, Saint Clair Shores, MI 48080-1700 | 2018-10-05 |
| 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 |
| 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 |
| 1104260066 | Rx Care of Mi LLC | Pharmacy | 25014 Little Mack Ave, Saint Clair Shores, MI 48080 | 2013-04-23 |
| Find all providers in zip 48080 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558906586 | Vincents Rx LLC | Pharmacy | 29619 Harper Ave, Saint Clair Shores, MI 48082-1640 | 2019-11-13 |
| 1750865416 | Saint Clair Family Pharmacy LLC | Pharmacy | 28001 Harper Ave., Saint Clair Shores, MI 48081 | 2018-09-19 |
| 1265865372 | Madhav Pharmacy LLC | Pharmacy | 24800 Harper Ave, Suite 2, Saint Clair Shores, MI 48080-1292 | 2013-08-12 |
| 1073615365 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 22515 Greater Mack Ave, Saint Clair Shores, MI 48080-2040 | 2006-09-05 |
| 1356453294 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 24001 Harper Ave, Saint Clair Shores, MI 48080-1467 | 2006-08-31 |
| 1083726913 | Woodward Detroit Cvs, L.l.c | Pharmacy | 27700 Harper Ave, Saint Clair Shores, MI 48081-1506 | 2006-08-31 |
| 1033221981 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 31240 Harper Ave, Saint Clair Shores, MI 48082-1402 | 2006-08-31 |
| 1467467589 | Walgreen Co | Pharmacy | 32201 Harper Ave, Saint Clair Shores, MI 48082-1408 | 2006-07-29 |
| 1891266607 | Saint Clair Shores Pharmacy LLC | Pharmacy | 23600 Harper Ave Ste 101, Saint Clair Shores, MI 48080-1445 | 2018-12-06 |
| 1790297596 | Saint Clair Pharmacy LLC | Pharmacy | 23600 Harper Ave Ste 101, Saint Clair Shores, MI 48080-1445 | 2017-11-02 |
| Find all providers in SAINT CLAIR SHORES | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48080 |
Please comment or provide details below to improve the information on PARK PHARMACY SCS LLC.
| 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.