# DEARBORN FAMILY PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Family Pharmacy LTC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316290729
- **Authorized official:** AIMAN ABUEIDA (OWNER)
- **Authorized official phone:** (313) 523-5334

## Contact information

- **Practice address:** 17000 EXECUTIVE PLAZA DR, SUITE 104, DEARBORN, MI 48126-2610
- **Practice address phone:** (313) 982-3770
- **Practice address fax:** (313) 982-3771
- **Mailing address:** 17000 EXECUTIVE PLAZA DR, SUITE 104, DEARBORN, MI 48126-2610
- **Mailing address phone:** (313) 982-3770
- **Mailing address fax:** (313) 982-3771

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 5301009879 | MI | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 10/23/2012
- **Last updated:** 09/22/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2377237 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |