Organization
WOODHAVEN MEDICAL CENTER PHARMACY INC
Active
Other names
WOODHAVEN MEDICAL CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALI NASSER RPH (OWNER)
(313) 581-8200
Entity
Organization
Contact information
Practice address
4700 GREENFIELD RD, DEARBORN, MI 48126-4124
(313) 581-8200
(313) 581-7141
Mailing address
4700 GREENFIELD RD, DEARBORN, MI 48126-4124
(313) 581-8200
(313) 581-7141
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
5301006509
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2356550
NCPDP
MI
01
—
540H216930
BCBSM DME
MI
05
—
873324521
—
MI
Enumeration date
10/06/2006
Last updated
07/14/2015
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