Organization
ADVANCED PHYSICIAN GROUP LLC
Active
Other names
Hannahs faith in humanity Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TAREK MAZLOUM RPH (PHARMACIST)
(734) 664-1147
Entity
Organization
Contact information
Practice address
13530 MICHIGAN AVE # L2, DEARBORN, MI 48126-3574
(734) 664-1147
Mailing address
317 MONTESANO PARK DR, IMPERIAL, MO 63052-2469
(573) 579-3360
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
01/21/2020
Last updated
07/09/2020
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