Organization
PHARMEDICA INC
Active
Other names
Rx Specialists DirectCare
Organization subpart
No
Provider details
NPI number
Authorized official
MOJEEB SHAHBAIN (PHCY MGR/OWNER)
(734) 744-4846
Entity
Organization
Contact information
Practice address
14155 FARMINGTON RD STE B, LIVONIA, MI 48154-5422
(734) 744-4846
(734) 744-4837
Mailing address
14155 FARMINGTON RD, SUITE B, LIVONIA, MI 48154-5422
(734) 744-4846
(734) 744-4837
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009726
MI
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457621955
—
MI
01
—
2376235
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/31/2011
Last updated
02/17/2012
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