Organization
RED CAP PHARMACY 002, LLC
Active
Other names
Red Cap Pharmacy 002, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE SHEHADI (CEO)
(313) 737-0691
Entity
Organization
Contact information
Practice address
2200 S WESTERN AVE STE F, CHICAGO, IL 60608-3816
(313) 737-0691
(313) 286-0220
Mailing address
37484 INTERCHANGE DR, FARMINGTON HILLS, MI 48335-1023
(313) 737-0691
(313) 286-0220
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
054.020246
IL
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168156
PK
—
Enumeration date
03/09/2017
Last updated
03/09/2017
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