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Organization

BLOSSOM CARE PHARMACY LLC

Active
Other names
BLOSSOM CARE PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
IMANE ALZAROUI RPH (OWNER, PIC, AO)
(313) 377-0793
Entity
Organization

Contact information

Practice address
5250 AUTO CLUB DR STE 160, DEARBORN, MI 48126-2619
(313) 436-5513
(313) 436-5405
Mailing address
5250 AUTO CLUB DR STE 160, DEARBORN, MI 48126-2619
(313) 436-5513
(313) 436-5405

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
5301010768
MI
3336C0004X
Compounding Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2155809
PK
05
2381363
MI
Enumeration date
12/07/2015
Last updated
01/20/2017
About Stedi
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