Organization
SAM'S PHARMACY PLLC
Active
Organization
SAM'S PHARMACY PLLC
Active
Other names
Sam's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BASSAM HARATI (PIC AND OWNER)
(313) 340-7777
Entity
Organization
Contact information
Practice address
14533 LIVERNOIS AVENUE, DETROIT, MI 48238-2010
(313) 340-7777
(313) 340-4449
Mailing address
14533 LIVERNOIS AVENUE, DETROIT, MI 48238-2010
(313) 340-7777
(313) 340-4449
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010118
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140569
PK
—
Enumeration date
06/18/2013
Last updated
09/14/2024
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