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Great Lakes Pharmacy LLC

Community/Retail Pharmacy in Wyandotte, MI · enumerated 2017 · authorized official Aniruddha Pathak, Ao.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1932648896

Verified

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Registry record

Entity type Organization (Type 2)
Legal business name Great Lakes Pharmacy LLC
Other name <Unavail>
Practice address 3247 Biddle Ave Ste A, Wyandotte, MI, 48192
Phone (734) 224-6400
Fax (734) 224-6500
Enumeration date Feb 13, 2017
Last updated in NPPES Jul 8, 2026

Taxonomy & classification

333600000X Pharmacy Suppliers Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 5301011109 (MI) Primary

Authorized official

Name Aniruddha Pathak
Title Ao
Phone (734) 284-5100

Other identifiers

Identifier Type State Issuer
2167778 Other - PK

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Great Lakes Pharmacy LLC located?
The practice location on file with NPPES is in Wyandotte, MI.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2026-07-08. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-07-08.