Organization
PREMIER HOME PHARMACY OF MI
Active
Organization
PREMIER HOME PHARMACY OF MI
Active
Other names
Premier Home Pharmacy of MI
Organization subpart
No
Provider details
NPI number
Authorized official
SYED RAZA (OWNER)
(734) 658-8985
Entity
Organization
Contact information
Practice address
23874 KEAN ST, SUITE 120, DEARBORN, MI 48124-1804
(313) 887-9111
(313) 887-4229
Mailing address
23874 KEAN ST, SUITE 120, DEARBORN, MI 48124-1804
(313) 887-9111
(313) 887-4229
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010075
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831441971
—
MI
01
—
2137422
PK
—
Enumeration date
10/13/2012
Last updated
03/02/2016
Update your record
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