Organization
INDIAN VILLAGE PHARMACY
Active
Organization
INDIAN VILLAGE PHARMACY
Active
Other names
INDIAN VILLAGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
IMAD Y AOUN RPH (PHARMACIST)
(313) 331-2000
Entity
Organization
Contact information
Practice address
8367 E JEFFERSON AVE, 8367 E JEFFERSON AVE, DETROIT, MI 48214-2730
(313) 331-2000
(313) 331-2001
Mailing address
8367 E JEFFERSON AVE, 8367 E JEFFERSON AVE, DETROIT, MI 48214-2730
(313) 331-2000
(313) 331-2001
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301007723
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2046489
PK
—
05
—
4548959
—
MI
Enumeration date
12/05/2006
Last updated
08/05/2025
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