Organization
MASHA-MOSS INC
Active
Other names
Family Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ABI O MASHA-MOSS RPH (CHIEF PHARMACIST)
(313) 563-1700
Entity
Organization
Contact information
Practice address
4245 S BEECH DALY RD, DEARBORN HEIGHTS, MI 48125
(313) 563-1700
(313) 563-2770
Mailing address
4245 S BEECH DALY RD, DEARBORN HEIGHTS, MI 48125
(313) 563-1700
(313) 563-2770
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301006924
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301006924
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4069218
—
MI
01
—
5301006924
MICHIGAN LICENSE
MI
Enumeration date
11/06/2005
Last updated
08/17/2018
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