Organization
COMMUNITY CARE RX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAISA JAMIE HIDER MD (OWNER)
(313) 889-8909
Entity
Organization
Contact information
Practice address
29484 FORD RD, GARDEN CITY, MI 48135-2318
(734) 743-3552
Mailing address
29484 FORD RD, GARDEN CITY, MI 48135-2318
(734) 743-3552
(734) 743-3561
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5301013030
STATE LICENSE
MI
Enumeration date
12/03/2019
Last updated
02/10/2026
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