Organization
CITY PHARMACY LLC
Active
Other names
City Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HUSSEIN CHAMMOUT (MANAGER,AO)
(313) 544-7144
Entity
Organization
Contact information
Practice address
15617 W MCNICHOLS RD, DETROIT, MI 48235-3541
(313) 544-7144
(313) 544-7147
Mailing address
15617 W MCNICHOLS RD, DETROIT, MI 48235-3541
(313) 544-7144
(313) 544-7147
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010667
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730575036
—
MI
01
—
2151398
PK
—
Enumeration date
04/13/2015
Last updated
05/27/2021
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