Organization
HAZEL PARK PHARMACY INC
Active
Other names
HAZEL PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MAKSUDALI SAIYAD (PIC OWNER)
(248) 835-8593
Entity
Organization
Contact information
Practice address
116 W 8 MILE RD, HAZEL PARK, MI 48030-2433
(248) 268-4504
(248) 268-4600
Mailing address
116 W 8 MILE RD, HAZEL PARK, MI 48030-2433
(248) 268-4504
(248) 268-4600
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301011038
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20161118499929
—
MI
01
—
2166000
PK
—
Enumeration date
10/26/2016
Last updated
12/18/2016
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