Organization
PRESTIGE MEDICAL, LLC
Active
Other names
Prestige Medical, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
FATIMA HAMADE (OWNER, AO)
(313) 879-5047
Entity
Organization
Contact information
Practice address
7940 N LILLEY RD, SUITE A-110, CANTON, MI 48187-2432
(313) 879-5047
(888) 726-0494
Mailing address
7940 N LILLEY RD, SUITE A-110, CANTON, MI 48187-2432
(313) 879-5047
(888) 726-0494
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010885
MI
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2158908
PK
—
Enumeration date
03/04/2016
Last updated
07/29/2016
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