Organization
MEDEX HEALTH MART
Active
Other names
MEDEX HEALTH MART
Organization subpart
No
Provider details
NPI number
Authorized official
IMAD MOHAMMAD (PHARMACY MANAGER)
(313) 397-2054
Entity
Organization
Contact information
Practice address
13970 WYOMING ST, DETROIT, MI 48238-2334
(313) 397-2054
(313) 397-2160
Mailing address
13970 WYOMING ST, DETROIT, MI 48238-2334
(313) 397-2054
(313) 397-2160
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009554
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2375550
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/04/2011
Last updated
08/08/2011
About Stedi
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