Organization
SAV MAX GLORY #2
Active
Other names
SAV MAX GLORY
Organization subpart
No
Provider details
NPI number
Authorized official
MAHMOUND RIFAI (PRESIDENT)
(313) 347-6022
Entity
Organization
Contact information
Practice address
14100 WOODWARD AVE, HIGHLAND PARK, MI 48203-2936
(313) 252-2400
(313) 252-2459
Mailing address
14100 WOODWARD AVE, HIGHLAND PARK, MI 48203-2936
(313) 252-2400
(313) 252-2459
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009178
MI
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2369470
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/02/2007
Last updated
09/15/2011
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