Organization
RICHARDSON MEDICAL PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAEL KHANAFER (PIC)
(313) 412-4622
Entity
Organization
Contact information
Practice address
29800 SOUTHFIELD RD, SOUTHFIELD, MI 48076-2037
(248) 557-6900
(248) 557-6901
Mailing address
29800 SOUTHFIELD RD, SOUTHFIELD, MI 48076-2037
(248) 557-6900
(248) 557-6901
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301008341
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2366967
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
2366967
—
MI
Enumeration date
02/15/2007
Last updated
01/17/2008
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