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USCG DETROIT PHARMACY
NPI 1801550843
Military/U.S. Coast Guard Pharmacy in Selfridge, MI

Active since October 26, 2021CLIA 23D1104227 · Waiver
43401 N JEFFERSON AVE BLDG 825, SELFRIDGE, MI 48045(586) 239-3005(586) 239-5010 Get Directions Write a Review

NPPES record last updated: October 26, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Uscg Detroit Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

USCG DETROIT PHARMACY (NPI 1801550843) is a healthcare organization registered as a military/u.s. coast guard pharmacy in Selfridge, Michigan and active in the NPI registry since October 2021. The organization holds a CLIA Waiver certificate valid through August 26, 2027 and lists Hector Morales, Chief Dha Pass, as its authorized official.

NPPES Registry Identity

NPI1801550843
Entity TypeOrganization
Primary Taxonomy332000000X
Legal Business NameUSCG DETROIT PHARMACY
Location Address43401 N JEFFERSON AVE BLDG 825Selfridge, MI 48045-5266
Mailing Address43401 N Jefferson Ave Bldg 825Selfridge, MI 48045-5266 · (586) 239-3005 · Fax (586) 239-5010
Phone(586) 239-3005
Fax(586) 239-5010
Organization SubpartNo
Authorized OfficialHector MoralesChief Dha Pass · (210) 536-6650
Enumeration DateOctober 26, 2021
NPPES CertifiedOctober 26, 2021
✔ NPI 1801550843 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary/U.S. Coast Guard PharmacySuppliers
Taxonomy Code332000000X
Definition
A Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services.
43401 N JEFFERSON AVE BLDG 825, Selfridge, MI 48045
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Other Names 1

Doing Business AsUscg Detroit Pharmacy

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D1104227

Uscg Detroit · Selfridge A N G B, MI
Active · expires Aug 26, 2027
CLIA Number23D1104227
Laboratory TypeMilitary Treatment
Certificate Effective DateAugust 27, 2025
Certificate Expiration DateAugust 26, 2027
Laboratory DirectorCapt Kevin Nolan
Laboratory Phone(586) 239-5017
Laboratory LocationUscg Detroit43401 N Jefferson Ave Bldg 825, Selfridge A N G B, MI 48045
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANA MARIE KUBINSKI RDH
Dental Hygienist
43401 N JEFFERSON AVE BLDG 825
SELFRIDGE ANGB, MI 48045
Macomb County (586) 239-3005
MRS. DIANA LEE KOTT RDH
Dental Hygienist
43401 N JEFFERSON AVE BLDG 825
SELFRIDGE ANGB, MI 48045
Macomb County (586) 239-3005
ISABELLE R DOHERTY
Military Health Care Provider (Independent Duty Corpsman)
43401 N JEFFERSON AVE BLDG 825
SELFRIDGE ANGB, MI 48045
Macomb County (231) 645-1261
MRS. CRYSTAL JUJUAN DAVIS R.D.H.
Dental Hygienist
43401 N JEFFERSON AVE BLDG 825, SELFRIDGE ANG BASE
SELFRIDGE ANGB, MI 48045
Macomb County (586) 239-3005

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Uscg Detroit Pharmacy's NPI number?

The NPI number for Uscg Detroit Pharmacy is 1801550843. It was assigned to this organization in the NPPES registry on October 26, 2021.

Where is Uscg Detroit Pharmacy located?

Uscg Detroit Pharmacy is located at 43401 N Jefferson Ave Bldg 825, Selfridge, MI 48045. The listed phone number is (586) 239-3005.

What is Uscg Detroit Pharmacy's specialty?

The primary specialty registered for this NPI is Military/U.S. Coast Guard Pharmacy with taxonomy code 332000000X.

Does Uscg Detroit Pharmacy hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D1104227) is associated with this NPI, valid through August 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Uscg Detroit Pharmacy accept?

Health plans from Medica list Uscg Detroit Pharmacy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Uscg Detroit Pharmacy was last updated on October 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.