Organization
MAPLE PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENGAMEH KHALEDI (PRESIDENT)
(248) 757-2503
Entity
Organization
Contact information
Practice address
5829 W MAPLE RD STE 129, WEST BLOOMFIELD, MI 48322-2294
(248) 757-2503
(248) 757-2847
Mailing address
5773 MILL POND CT, WEST BLOOMFIELD, MI 48322-2078
(248) 342-0314
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
5301010400
MI
333600000X
Pharmacy
5301010400
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301010400
MI
3336S0011X
Specialty Pharmacy
5301010400
MI
Other
Enumeration date
04/14/2014
Last updated
11/05/2014
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