Organization
BELAVISTA DRUGS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIHAD H BEYDOUN R PH (OWNER CHIEF PHARMACIST)
(734) 282-1940
Entity
Organization
Contact information
Practice address
15830 FORT ST, SUITE 5, SOUTHGATE, MI 48195-1367
(734) 282-1940
(734) 282-1539
Mailing address
15830 FORT ST, SUITE 5, SOUTHGATE, MI 48195-1367
(734) 282-1940
(734) 282-1539
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301008225
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2367616
—
MI
Enumeration date
02/13/2007
Last updated
10/22/2014
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