MEDICARE: STELLAMARIS EMENIKE PHARMACIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	5302418343	MI

General Provider Information

NPI Number	:	1942166624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STELLAMARIS EMENIKE PHARMACIST

Provider Business Mailing Address
First Line	:	511 CASTLE DR APT C
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21212-2319
Country	:	US
Telephone Number	:	240-971-6911
Fax Number	:

Provider Business Practice Location Address
First Line	:	5091 US 41 S
Second Line	:
City	:	HARVEY
State	:	MI
Zip	:	49855-9001
Country	:	US
Telephone Number	:	906-249-1441
Fax Number	:	906-249-9850

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2025
Last Update Date	:	12/26/2025

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Directions to “ STELLAMARIS EMENIKE PHARMACIST” Practice Location

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