Organization
ABES DRUG STORE 102 LLC
Active
Organization
ABES DRUG STORE 102 LLC
Active
Other names
Abe's Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
RAMZI KASSEM PHARMD (PARTNER)
(313) 377-6623
Entity
Organization
Contact information
Practice address
30695 LITTLE MACK AVE STE F, ROSEVILLE, MI 48066-1771
(586) 459-0836
(586) 571-0650
Mailing address
13770 E 12 MILE RD, WARREN, MI 48088-3751
(586) 459-0836
(586) 571-0650
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5301013171
PHARMACY LICENSE
MI
01
—
5315242183
PHARMACY CONTROLLED SUBSTANCE LICENSE
MI
Enumeration date
11/09/2020
Last updated
11/30/2023
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