Organization
MATRIX PHARMACY,LLC
Active
Organization
MATRIX PHARMACY,LLC
Active
Other names
Matrix Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAMEELA HEPBURN (OWNER)
(313) 231-6627
Entity
Organization
Contact information
Practice address
5827 E 13 MILE RD, WARREN, MI 48092-1512
(586) 883-6047
(586) 883-6159
Mailing address
5827 E 13 MILE RD, WARREN, MI 48092-1512
(586) 883-6047
(586) 883-6159
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396204129
—
MI
05
—
1821573130
—
MI
Enumeration date
10/02/2018
Last updated
06/04/2020
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