Organization
EASTBORN RX PHARMACY LLC
Active
Other names
Eastborn RX Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALI CHEAITO PHARMD (OWNER)
(313) 491-1010
Entity
Organization
Contact information
Practice address
7526 WYOMING ST, SUITE 1, DEARBORN, MI 48126-1690
(313) 491-1010
(313) 491-2020
Mailing address
7526 WYOMING ST, SUITE 1, DEARBORN, MI 48126-1690
(313) 491-1010
(313) 491-2020
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009915
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2137262
PK
—
Enumeration date
07/25/2012
Last updated
08/09/2024
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