Organization
PARK MEDICAL RX LLC
Active
Other names
Park Medical Rx LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MAITHAM ALSHARIFI (PHARMACIST)
(313) 930-2185
Entity
Organization
Contact information
Practice address
20720 PLYMOUTH RD, DETROIT, MI 48228-1275
(313) 651-5887
(313) 651-5889
Mailing address
20720 PLYMOUTH RD, DETROIT, MI 48228-1275
(313) 651-5887
(313) 651-5889
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301010727
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154994
PK
—
Enumeration date
09/29/2015
Last updated
03/02/2017
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