Organization
ABE S PHARMACY LLC
Active
Other names
Abe's Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
HUSSEIN MANSOUR PHARMD (PIC)
(313) 686-8666
Entity
Organization
Contact information
Practice address
13760 E 12 MILE RD STE B, WARREN, MI 48088-3751
(586) 362-8404
(586) 251-0322
Mailing address
13760 E 12 MILE RD STE B, WARREN, MI 48088-3751
(586) 362-8404
(586) 251-0322
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301011084
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013453950
—
MI
01
—
2167138
PK
—
Enumeration date
01/17/2017
Last updated
06/22/2021
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