Organization
ROSEDALE COMMUNITY PHARMACY INC
Active
Other names
ROSEDALE COMMUNITY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ZAINAB JAAFAR (PRESIDENT)
(734) 262-4600
Entity
Organization
Contact information
Practice address
19220 GRAND RIVER AVE, DETROIT, MI 48223-1707
(313) 531-0100
(313) 531-0101
Mailing address
PO BOX 532258, LIVONIA, MI 48153-2258
(313) 531-0100
(313) 531-0101
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009296
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699007542
—
MI
01
—
2123723
PK
—
Enumeration date
02/03/2010
Last updated
11/18/2014
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