Organization
GRAND LAHSER PHARMACY LLC
Active
Other names
PharMor Pharmacy- Grand Lahser
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED SOHOUBAH PHR, SHRM-CP (MEMBER OWNER)
(248) 663-3380
Entity
Organization
Contact information
Practice address
21673 GRAND RIVER AVE, DETROIT, MI 48219-3219
(313) 533-0500
(313) 533-0501
Mailing address
21673 GRAND RIVER AVE, DETROIT, MI 48219-3219
(248) 663-3380
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301010005
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508105404
—
MI
01
—
2138881
PK
—
Enumeration date
02/12/2013
Last updated
07/09/2015
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