Organization
PACKARD DISCOUNT PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDULLA SHARIFF (OWNER, PIC, AO)
(313) 633-9310
Entity
Organization
Contact information
Practice address
4726 GREENFIELD RD STE 101, DEARBORN, MI 48126-4124
(313) 633-9310
(313) 633-9706
Mailing address
4726 GREENFIELD RD STE 101, DEARBORN, MI 48126-4124
(313) 633-9310
(313) 633-9706
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010936
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194171850
—
MI
01
—
2160247
PK
—
Enumeration date
05/11/2016
Last updated
12/19/2017
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