Organization
PRESTIGE SPECIALTY PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMRO SHARAFELDIN (CEO)
(877) 742-7621
Entity
Organization
Contact information
Practice address
3739 15 MILE RD, STERLING HEIGHTS, MI 48310
(877) 742-7621
(586) 883-9388
Mailing address
3739 15 MILE RD, STERLING HEIGHTS, MI 48310
(877) 742-7621
(586) 883-9388
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306340955
—
MI
01
—
2177646
PK
—
Enumeration date
05/14/2018
Last updated
06/05/2018
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