Organization
BELAVISTA DRUGS
Active
Organization
BELAVISTA DRUGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIHAD H BEYDOUN R,PH (REGISTERED PHARMACIST)
(734) 282-1940
Entity
Organization
Contact information
Practice address
15830 FORT ST, SUITE 5, SOUTHGATE, MI 48195-1367
(734) 282-1940
(734) 282-1953
Mailing address
15830 FORT ST, SUITE 5, SOUTHGATE, MI 48195-1367
(734) 282-1940
(734) 282-1953
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
5301008225
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301008225
MI
Other
Enumeration date
09/10/2005
Last updated
09/17/2009
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