Organization
BIOMED PHARMACY-DETROIT, LLC
Active
Organization
BIOMED PHARMACY-DETROIT, LLC
Active
Other names
BioMed Specialty Pharmacy-Detroit
Organization subpart
No
Provider details
NPI number
Authorized official
MAZEN BAISA (OWNER)
(855) 246-6338
Entity
Organization
Contact information
Practice address
113 E CANFIELD ST STE C, DETROIT, MI 48201-1878
(313) 831-9350
(313) 831-9356
Mailing address
113 E CANFIELD ST, SUITE C, DETROIT, MI 48201-1878
(313) 831-9350
(313) 831-9356
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009790
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2376653
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/23/2012
Last updated
04/23/2012
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