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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