Organization
EXECUTIVE INFUSION SERVICES LLC
Active
Other names
Executive Infusion Services Grand Blanc
Organization subpart
No
Provider details
NPI number
Authorized official
AIMAN ABUEIDA (OWNER / CLINICAL PHARMACIST)
(313) 982-3220
Entity
Organization
Contact information
Practice address
12821 D-13 S. SAQINAW ST, GRAND BLANK, MI 48439
(313) 982-3220
(313) 982-3221
Mailing address
17000 EXECUTIVE PLAZA DR, SUITE 201 - B, DEARBORN, MI 48126-2793
(313) 982-3221
(313) 982-3221
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
5301010096
MI
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2165926
PK
—
Enumeration date
11/02/2016
Last updated
12/21/2016
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