Organization
GATEWAY PHARMACY INC.
Active
Other names
gateway pharmacy inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MUSTAFA A ALSAMARAE RPH (OFFICER)
(313) 835-9999
Entity
Organization
Contact information
Practice address
15690 JOY RD, DETROIT, MI 48228
(313) 835-9999
(313) 835-6539
Mailing address
15690 JOY RD, DETROIT, MI 48228
(313) 835-9999
(313) 835-6539
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301007360
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2362488
—
MI
Enumeration date
01/08/2007
Last updated
01/04/2017
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