Organization
WEST WARREN PHARMACY
Active
Other names
PharMor Pharmacy-West Warren
Organization subpart
No
Provider details
NPI number
Authorized official
ABDO SHOUBAH (OWNER)
(248) 663-3380
Entity
Organization
Contact information
Practice address
6461 W WARREN AVE STE 100, DETROIT, MI 48210-1176
(313) 894-2866
(313) 894-2867
Mailing address
23815 NORTHWESTERN HWY, SUITE 200, SOUTHFIELD, MI 48075-7738
(248) 663-3380
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5315065672
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2145809
PK
—
Enumeration date
05/20/2014
Last updated
05/20/2014
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