DEBORAH BOURQUIN (NPI# 1821521683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821521683 |
| Entity Type | Individual |
| Full Name | DEBORAH BOURQUIN |
| Credential | PHARMD |
| Practice Address |
45540 Michigan Ave Canton MI 48188-2472 |
| Mailing Address |
36430 Ford Rd Westland MI 48185-2211 |
| Practice Telephone | 7343972560 |
| Practice Fax Number | 7343972691 |
| Enumeration Date | 2017-04-09 |
| Last Update Date | 2019-12-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | RP0008876 | WV | Pharmacy Service Providers |
| N | 183500000X | Pharmacist | 5302040176 | MI | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
5302040176 | MI | Pharmacy Service Providers |
| Street Address |
45540 MICHIGAN AVE |
| City | CANTON |
| State | MI |
| Zip Code | 48188-2472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942234711 | Kroger Co of Michigan | Durable Medical Equipment & Medical Supplies | 45540 Michigan Ave, Canton, MI 48188-2472 | 2006-07-10 |
| 1417596453 | Wafa Altamam | Pharmacist | 45540 Michigan Ave, Canton, MI 48188-2472 | 2019-12-21 |
| 1356987515 | Carla Soule-pearson | Pharmacist | 45540 Michigan Ave, Canton, MI 48188-2472 | 2019-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437766425 | Kesha Glimps | Home Health Aide | 513 Cherry Orchard, Canton, MI 48188 | 2020-09-24 |
| 1881222578 | Darlenda Knuckles | Licensed Practical Nurse | 43825 Michigan Ave, Canton, Mi 48188, Canton, MI 48188 | 2020-03-30 |
| 1023646049 | Nikeyta Catrice Evans | Licensed Practical Nurse | 43825 Michign Ave Suite 2, Canton, MI 48188 | 2020-03-27 |
| 1013473925 | Yen Do Ruiz | Pharmacist | 41460 Haggerty Circle South, Canton, MI 48188 | 2019-02-15 |
| 1366938607 | Abidi Mehdi Medical, Pllc | Internal Medicine | 44237 Michigan Avenue, Canton, MI 48188 | 2018-07-10 |
| 1720589427 | Audrey Imbur | Physical Therapist | 4111 S. Canton Center Rd, Canton, MI 48188 | 2018-02-27 |
| 1639687700 | Tanveer Hussain | Physical Therapist | 3439 Brooklyn Dr, Canton, MI 48188 | 2018-01-11 |
| 1376054833 | Cherry Hill Village Pharmacy LLC | Pharmacy | 50429 Independence St, Canton, MI 48188 | 2017-10-23 |
| 1396262101 | Enid Alexandra Moore | Social Worker | 40946 Crossbow Cir, Apt 201, Canton, MI 48188 | 2017-08-23 |
| 1922520865 | Marc Slotnick | Peer Specialist | 43825 Michigan Ave., Canton, MI 48188 | 2017-07-12 |
| Find all providers in zip 48188 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174164826 | Amy Sandhu Khan | Pharmacist | 5860 N Canton Center Rd Ste 340, Canton, MI 48187-2687 | 2019-10-03 |
| 1336747161 | Chelsea Dunn | Pharmacist | 6766 Hickory Flat Hwy, Canton, GA 30115-9224 | 2020-10-14 |
| 1134727332 | Sarah Khan | Pharmacist | 41460 Haggerty Cir S, Canton, MI 48188-2227 | 2020-10-12 |
| 1457982431 | Emilie Lobeck | Pharmacist | 4045 Marietta Hwy, Canton, GA 30114-8600 | 2020-01-29 |
| 1710518782 | Catherine Rachel Dover | Pharmacist | 6766 Hickory Flat Hwy, Canton, GA 30115-9224 | 2020-01-29 |
| 1811528805 | James Byron Rodgers Jr. | Pharmacist | 4045 Marietta Hwy, Canton, GA 30114-8600 | 2020-01-29 |
| 1720619869 | Karen Marie Norris | Pharmacist | 4045 Marietta Hwy, Canton, GA 30114-8600 | 2020-01-28 |
| 1740810456 | Brian James West | Pharmacist | 8020 Cumming Hwy, Canton, GA 30115-9337 | 2020-01-22 |
| 1811527765 | Bela Palmer | Pharmacist | 6766 Hickory Flat Hwy, Canton, GA 30115-9224 | 2020-01-20 |
| 1417596453 | Wafa Altamam | Pharmacist | 45540 Michigan Ave, Canton, MI 48188-2472 | 2019-12-21 |
| Find all providers in CANTON | ||||
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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.