Organization
GLORY PHARMACY- JOSEPH CAMPAU LLC
Active
Organization
GLORY PHARMACY- JOSEPH CAMPAU LLC
Active
Other names
PharMor Pharmacy-Joseph Campau
Organization subpart
No
Provider details
NPI number
Authorized official
MURSALA AHMED RPH (OWNER/CHIEF PHARMACIST)
(313) 871-2020
Entity
Organization
Contact information
Practice address
9023 JOSEPH CAMPAU ST, HAMTRAMCK, MI 48212-3726
(313) 871-2020
(313) 871-2028
Mailing address
2385 NORTHWESTERN HWY, SUITE 200, SOUTHFIELD, MI 48075
(248) 663-3380
(248) 223-1060
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009939
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316281140
—
MI
01
—
2137624
PK
—
Enumeration date
11/16/2012
Last updated
11/25/2015
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