Organization
EASTERN MICHIGAN PHARMACY INC
Active
Other names
Eastern MIchigan Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SAMI DABAJA RPH (OWNER)
(734) 485-9900
Entity
Organization
Contact information
Practice address
1159 E MICHIGAN AVE, YPSILANTI, MI 48198-5807
(734) 485-9900
(734) 485-9300
Mailing address
1159 E MICHIGAN AVE, YPSILANTI, MI 48198-5807
(734) 485-9900
(734) 485-9300
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301008958
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2371831
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/22/2008
Last updated
11/03/2009
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