Organization
MEDSTAR PHARMACY INC
Active
Other names
MEDSTAR PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SADUF IRSHAD (OWNER)
(734) 624-7808
Entity
Organization
Contact information
Practice address
14155 FARMINGTON RD STE D, LIVONIA, MI 48154-5422
(734) 744-5266
(734) 744-4854
Mailing address
14155 FARMINGTON RD STE D, SUITE D, LIVONIA, MI 48154-5422
(734) 744-5266
(734) 744-4854
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301010018
MI
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538408695
—
MI
01
—
2138936
PK
—
Enumeration date
02/10/2013
Last updated
11/10/2014
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