Organization
SUPER MART PHARMACY PC
Active
Other names
Super Mart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ZAFAR AZIZ (PRESIDENT)
(313) 371-7865
Entity
Organization
Contact information
Practice address
12230 E 8 MILE RD, DETROIT, MI 48205-1048
(313) 371-7865
(313) 371-7875
Mailing address
12230 E 8 MILE RD, DETROIT, MI 48205-1048
(313) 371-7865
(313) 371-7875
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009405
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2128828
PK
—
Enumeration date
01/05/2011
Last updated
08/01/2013
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