Organization
RED CAP PHARMACY 001 LLC
Active
Organization
RED CAP PHARMACY 001 LLC
Active
Other names
Red Cap Pharmacy 001
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMAD ISSA ABOUKHODR (OWNER)
(517) 879-4877
Entity
Organization
Contact information
Practice address
214 N WEST AVE STE A, JACKSON, MI 49201-1903
(517) 879-4877
(517) 879-1873
Mailing address
214 N. WEST AVE STE A, JACKSON, MI 49201
(517) 879-4877
(517) 879-1873
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301011054
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166443
PK
—
Enumeration date
11/29/2016
Last updated
01/09/2023
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