Organization
CORKTOWN PHARMACY LLC
Active
Other names
Corktown Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
EMAD SALEH (MEMBER)
(313) 414-7170
Entity
Organization
Contact information
Practice address
1726 HOWARD ST, SUITE 200, DETROIT, MI 48216-1921
(313) 414-7170
Mailing address
23487 HILL ST, DEARBORN HEIGHTS, MI 48127-2382
(313) 414-7170
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164664
PK
—
Enumeration date
10/12/2016
Last updated
10/14/2016
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