Organization
ANDY'S MOTOWN PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISMAIL JADALLAH (OWNER)
(313) 341-2450
Entity
Organization
Contact information
Practice address
14470 LIVERNOIS AVE, DETROIT, MI 48238-2005
(313) 341-2450
Mailing address
14470 LIVERNOIS AVE, DETROIT, MI 48238-2005
(313) 341-2450
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301008407
MI
Other
Enumeration date
06/16/2006
Last updated
01/16/2008
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