Organization
PARK MEDICAL PHARMACY INC
Active
Other names
Park Medical Pharmacy Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MAITHAM ALSHARIFI (PHARMACIST)
(313) 651-5887
Entity
Organization
Contact information
Practice address
20720 PLYMOUTH RD, DETROIT, MI 48228-1275
(313) 288-2203
Mailing address
20720 PLYMOUTH RD, DETROIT, MI 48228-1275
(313) 288-2203
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009761
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2376095
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/29/2011
Last updated
12/16/2014
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