Organization
DEARBORN FRESH PHARMACY INC
Active
Other names
New Max Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NABIL HAWILY (OWNER)
(313) 455-1592
Entity
Organization
Contact information
Practice address
5472 SCHAEFER RD, DEARBORN, MI 48126-3223
(313) 584-4600
(313) 584-3784
Mailing address
13661 COLSON ST STE A, DEARBORN, MI 48126-3232
(313) 581-8801
(313) 581-8802
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009774
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133820
PK
—
Enumeration date
03/02/2012
Last updated
02/23/2022
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