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Organization

HENRY FORD HEALTH SYSTEM

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SURA ABDULLAH (PHARMACIST)
(248) 325-3820
Entity
Organization

Contact information

Practice address
6777 W MAPLE RD, OUTPATIENT PHARMACY, WEST BLOOMFIELD, MI 48322-3013
(248) 325-3820
(248) 325-3825
Mailing address
6777 W MAPLE RD, OUTPATIENT PHARMACY, WEST BLOOMFIELD, MI 48322-3013
(248) 325-3820
(248) 325-3825

Taxonomy

Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5302033171
STATE LICENSE NUMBER
MI
Enumeration date
04/06/2015
Last updated
04/06/2015
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