GREAT LAKES RX SAV MOR PHARMACY (NPI# 1982888947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982888947 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES RX SAV MOR PHARMACY |
| Other Organization Name | GREAT LAKES RX PHARMACY |
| Practice Address |
1770 Fort St Lincoln Park MI 48146-1904 |
| Practice Telephone | 3138279999 |
| Practice Fax Number | 3138270999 |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2009-05-08 |
| Authorized Official Name | WAEL KHANAFER (OWNER) |
| Authorized Official Telephone | 1334124622 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5301008773 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP PROVIDER IDENTIFICATION NUMBER | 2370702 | 01 |
| Other Name | Type Code |
|---|---|
| GREAT LAKES RX PHARMACY | Doing Business As Name - Organization |
| Street Address |
1770 FORT ST |
| City | LINCOLN PARK |
| State | MI |
| Zip Code | 48146-1904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518582485 | Harvey Bouru | Physician Assistant | 1770 Fort St, Lincoln Park, MI 48146-1904 | 2020-06-16 |
| 1003453879 | Get Well Pharmacy, LLC | Pharmacy | 1770 Fort St, Lincoln Park, MI 48146-1904 | 2019-11-29 |
| 1922669928 | Parks Downriver Physical Therapy LLC | Clinic/Center | 1770 Fort St, Lincoln Park, MI 48146-1904 | 2019-06-21 |
| 1578035317 | Get Well Urgent Care Downriver Plc | Clinic/Center | 1770 Fort St, Lincoln Park, MI 48146-1904 | 2018-12-18 |
| 1881909869 | Great Lakes Sav-rite | Pharmacy | 1770 Fort St, Lincoln Park, MI 48146-1904 | 2010-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356967251 | Luisa Sofia Amaya | Behavior Technician | 1360 Porter Ave, Lincoln Park, MI 48146 | 2020-06-17 |
| 1851854129 | Abhi Patel | Physical Therapist | 25050 W. Outer Dr, Ste: 204, Lincoln Park, MI 48146 | 2019-04-12 |
| 1831608827 | Back On Track Physical Therapy LLC | Clinic/Center | 1132 Southfield Road, Lincoln Park, MI 48146 | 2017-09-22 |
| 1326568221 | Priscilla Cano | Social Worker | 1600 Porter, Detroit, MI 48146 | 2017-06-21 |
| 1952650194 | Melissa Margaret Belinc | Psychologist | 26300 Outer Drive, Lincoln Park, MI 48146 | 2012-09-04 |
| 1497011746 | Richard John Daniels | Physical Therapy Assistant | 1538 Morris, Lincoln Park, MI 48146 | 2012-04-11 |
| 1740563261 | Myesha Renee Thurman | Social Worker | 26180 W. Outer Drive, Lincoln Park, MI 48146 | 2011-09-21 |
| 1033491162 | Heidi Bremer | Social Worker | 26180 West Outer Drive, Lincoln Park, MI 48146 | 2011-09-14 |
| 1871823526 | Richard Dale Mott | Counselor | 1564 Arlington, Lincoln Park, LA 48146 | 2009-12-31 |
| 1386801777 | Laura Ann Kaakati-weber | Psychologist | 26184 West Outer Drive, Lincoln Park, MI 48146 | 2008-05-22 |
| Find all providers in zip 48146 | ||||
| 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 |
|---|---|---|---|---|
| 1073099701 | Fort St Rx Pharmacy LLC | Pharmacy | 2017 Fort St, Lincoln Park, MI 48146-2402 | 2018-07-16 |
| 1407262702 | Greatness LLC | Pharmacy | 1158 Fort St, Lincoln Park, MI 48146-1840 | 2014-07-08 |
| 1558615740 | The Rite Pharmacy LLC | Pharmacy | 3504 Fort St, Lincoln Park, MI 48146-4102 | 2012-11-09 |
| 1265719892 | Downriver Drugs | Pharmacy | 4045 Dix Hwy, Lincoln Park, MI 48146-3934 | 2011-11-10 |
| 1568554160 | New Jersey Cvs Pharmacy LLC | Pharmacy | 15 Boonton Tpke, Lincoln Park, NJ 07035-1761 | 2006-09-29 |
| 1265534549 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 2400 Fort St, Lincoln Park, MI 48146-2496 | 2006-09-05 |
| 1215039565 | Woodward Detroit Cvs, L.L.C. | Pharmacy | 3647 Dix Hwy, Lincoln Park, MI 48146-3801 | 2006-09-05 |
| 1003453879 | Get Well Pharmacy, LLC | Pharmacy | 1770 Fort St, Lincoln Park, MI 48146-1904 | 2019-11-29 |
| 1811494115 | Rite Health Pharmacy Fort LLC | Pharmacy | 1158 Fort St, Lincoln Park, MI 48146-1840 | 2018-04-12 |
| 1356737035 | Princes Pharmacy LLC | Pharmacy | 26190 Outer Dr, Suite 120, Lincoln Park, MI 48146-2084 | 2015-04-09 |
| Find all providers in LINCOLN PARK | ||||
| City | LINCOLN PARK |
| Zip Code | 48146 |
Please comment or provide details below to improve the information on GREAT LAKES RX SAV MOR PHARMACY.
| 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.