Organization
DABAJA PHARMACY LLC
Active
Other names
Dabaja Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MOE DAJABA (MEMBER)
(313) 212-8165
Entity
Organization
Contact information
Practice address
2610 WASHTENAW RD, YPSILANTI, MI 48197-1505
(734) 528-9400
(734) 528-9406
Mailing address
2610 WASHTENAW RD, YPSILANTI, MI 48197-1505
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009017
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2372237
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/19/2008
Last updated
01/06/2009
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