Organization
SAV-MART PHARMACY GRATIOT LLC
Active
Other names
Sav-Mart Pharmacy II
Organization subpart
No
Provider details
NPI number
Authorized official
ABDO SHOUBAH (OWNER)
(313) 923-0007
Entity
Organization
Contact information
Practice address
7011 GRATIOT AVE, DETROIT, MI 48207-1973
(313) 923-0007
(313) 923-0098
Mailing address
7011 GRATIOT AVE, DETROIT, MI 48207-1973
(313) 923-0007
(313) 923-0098
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009409
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2366359
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/20/2007
Last updated
11/30/2010
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