Organization
PIONEER PHARMACY 1 INC
Active
Organization
PIONEER PHARMACY 1 INC
Active
Other names
Pioneer Pharmacy 1 INC
Organization subpart
No
Provider details
NPI number
Authorized official
ALI MOUKDAD (OWNER/PIC)
(248) 957-8456
Entity
Organization
Contact information
Practice address
39575 W 10 MILE RD, STE 204, NOVI, MI 48375-2949
(248) 957-8456
(248) 536-2074
Mailing address
39575 W 10 MILE RD, STE 204, NOVI, MI 48375-2949
(248) 957-8456
(248) 536-2074
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010808
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2157936
PK
—
Enumeration date
01/08/2016
Last updated
08/02/2016
Update your record
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