Organization
GREAT LAKES MEDICAL PHARMACY LLC
Active
Other names
All American Medical Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RAMI LAZEKI (PHARMACIST-IN-CHARGE)
(305) 455-3836
Entity
Organization
Contact information
Practice address
23247 PINEWOOD ST, STE 100, WARREN, MI 48091-4754
(954) 381-7146
(877) 448-0633
Mailing address
23247 PINEWOOD ST, STE 100, WARREN, MI 48091-4754
(866) 576-5040
(877) 448-0633
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010234
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164692356
—
MI
01
—
2144902
PK
—
Enumeration date
03/04/2008
Last updated
07/05/2016
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