Organization
SIX MILE PHARMACY LLC
Active
Organization
SIX MILE PHARMACY LLC
Active
Other names
Six Mile Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NAZMIEH JADALLAH (OWNER)
(313) 397-7254
Entity
Organization
Contact information
Practice address
7145 W MCNICHOLS RD, DETROIT, MI 48221-2664
(313) 397-7254
(313) 397-7048
Mailing address
7145 W MCNICHOLS RD, DETROIT, MI 48221-2664
(313) 397-7254
(313) 397-7048
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009401
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2374469
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
2374469
—
MI
Enumeration date
08/13/2010
Last updated
01/30/2013
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