Organization
MED DRUG PHARMACY INC
Active
Other names
Med Drug Pharmacy Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MUSTAFA ALSAMARAE (PHARMACIST)
(313) 835-9999
Entity
Organization
Contact information
Practice address
26206 W 12 MILE RD STE 108, SOUTHFIELD, MI 48034-1799
(248) 262-7740
(248) 262-7741
Mailing address
26206 W 12 MILE RD STE 108, SOUTHFIELD, MI 48034-1799
(248) 351-0943
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009757
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2376108
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/29/2011
Last updated
05/09/2012
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