Organization
FORD-TEL PHARMACY INC
Active
Organization
FORD-TEL PHARMACY INC
Active
Other names
Vital Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BASSAM TAYSIR HAMMOUD RPH (PHARMACIST IN CHARGE)
(313) 274-4647
Entity
Organization
Contact information
Practice address
23800 FORD RD, DEARBORN HEIGHTS, MI 48127
(313) 274-4647
(313) 274-6249
Mailing address
23800 FORD RD, DEARBORN HEIGHTS, MI 48127
(313) 274-4647
(313) 274-6249
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5401005762
MI
3336C0003X
Community/Retail Pharmacy
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2350231
NCPDP
MI
01
—
540Q204140
BCBSM DME
MI
05
—
872879783
—
MI
Enumeration date
01/16/2007
Last updated
03/14/2016
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