MR. JONATHAN VICTOR VAN LARE


Address: 22777 W 11 Mile Rd, Southfield, MI 48034-2152
Phone: 2483589160

MR. JONATHAN VICTOR VAN LARE (NPI# 1952520462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952520462
Entity Type Individual
Full Name MR. JONATHAN VICTOR VAN LARE
Credential PHARM. D.
Practice Address 22777 W 11 Mile Rd
Southfield
MI 48034-2152
Mailing Address 1393 Moy Avenue
Windsor
ONTARIO N8X 4S5
CA
Practice Telephone 2483589160
Mailing Telephone 5192530605
Enumeration Date 2007-04-24
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 183500000X Pharmacist 5302035070 MI Pharmacy Service Providers

Office Location

Street Address 22777 W 11 MILE RD
City SOUTHFIELD
State MI
Zip Code 48034-2152

Providers in the same location

NPI Name Taxonomy Address Enumeration
1356435754 Henry Ford Health System Pharmacy 22777 W 11 Mile Rd, Southfield, MI 48033-2152 2006-10-03
1043713647 Linda Jean Mahome Physical Therapist 22777 W 11 Mile Rd, Southfield, MI 48033-2152 2018-03-10
1043732068 Brittany Michelle Schwanke Behavioral Analyst 22777 W 11 Mile Rd, Southfield, MI 48033-2152 2017-07-11
1033669122 Jenny Wai-yin Lin Pharmacist 22777 W 11 Mile Rd, Southfield, MI 48033-2152 2016-10-12
1326422908 Marisa Elias Pediatrics 22777 W 11 Mile Rd, Southfield, MI 48033 2015-07-14
1811376577 Mariana Fraga I Behavioral Analyst 22777 W 11 Mile Rd, Southfield, MI 48033-2152 2015-05-27
1013348051 Hfhs Center for Autism and Developmental Disabilities Clinic/Center 22777 W 11 Mile Rd, Southfield, MI 48033-2152 2013-12-02
1134412679 Dina Faig Ibrahim Family Medicine 22777 W 11 Mile Rd, Southfield, MI 48033-2152 2011-05-17
1477764272 Horace Horn II Pharmacist 22777 W 11 Mile Rd, Southfield, MI 48034-2152 2007-05-24
1831318849 Meloneze Renee Blackman Pharmacy Technician 22777 W 11 Mile Rd, Southfield, MI 48033-2152 2007-04-25
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780219196 I. R. Horn & Associates LLC Community/Behavioral Health 29623 Norhtwestern Hwy Suite 5, Southfield, MI 48034 2020-03-05
1003378753 Alexis Shivers Physical Therapy Assistant 27500 Lahser Rd, Southfield, MI 48034 2019-04-02
1598257768 El-abbadi Pediatric Clinic Pediatrics 24676 Lahser Road, Southfield, MI 48034 2018-06-04
1689166894 Recore Rehabilitation Services Clinic/Center 25899 W 12 Mile Rd # 340, Southfield, MI 48034 2018-06-04
1578063749 El-abbadi Healthcare Center Clinic/Center 27403 Lahser Rd, Southfield, MI 48034 2018-02-14
1063924819 Diagnostic Hematology, PC Clinical Medical Laboratory 24725 W. Twelve Mile Road, Suite 118, Southfield, MI 48034 2017-11-02
1962929125 Toms Holistic Home Visits Pllc Clinic/Center 28675 Franklin Rd, Suite 217, Southfield, MI 48034 2017-08-28
1265956940 Abbadi Healthcare Pharmacy 27402 Lahser Road, Southfield, MI 48034 2017-08-03
1720517113 Theramedic Home Health Care LLC Home Health 26400 W. 12 Mile Rd, Suite 80, Southfield, MI 48034 2017-06-08
1538695804 Adrienne Rutherford Occupational Therapist 25999 Franklin Pointe Dr, Southfield, MI 48034 2017-05-05
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Taxonomy Information

Taxonomy Code 183500000X
Grouping Pharmacy Service Providers
Classification Pharmacist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1366073363 Menaka Ravi Chandra Reddy Pharmacist 23881 Greenfield Rd, Southfield, MI 48075-3122 2020-01-28
1013548114 Dina Issa Pharmacist 26026 W 12 Mile Rd # Oad, Southfield, MI 48034-1783 2020-01-28
1285127290 Hitesh P Upadhyay Pharmacist 23832 Southfield Rd Ste 2, Southfield, MI 48075-8001 2018-06-13
1558879064 Mohamed Sohoubah Pharmacist 23815 Northwestern Hwy Ste 200, Southfield, MI 48075-7738 2018-01-18
1881061984 Peter Ponomarev Pharmacist 15600 W 10 Mile Rd Unit 1b, Southfield, MI 48075-2148 2015-08-25
1679967038 Remy Onimoe Pharmacist 16191 Livernois Avenue, Southfield, MI 48221 2015-03-24
1477828457 Eric Jeffery Lee Pharmacist 22277 W 12 Mile Rd, Apt 29, Southfield, MI 48034-4621 2012-03-09
1619240504 Erwin H Posner Pharmacist 28422 Tavistock Trl, Southfield, MI 48034-2019 2012-02-22
1013291970 Boby Abraham Pharmacist 23111 Lahser Road, Walgreens, Southfield, MI 48034 2011-10-10
1053694521 Donna K Spencer Pharmacist 26776 W 12 Mile Rd Ste 108, Southfield, MI 48034-7807 2011-09-21
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Competitor

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City SOUTHFIELD
Zip Code 48034

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Dataset Information

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.

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