Organization
QUALICARE RX, LLC
Active
Other names
Qualicare Rx, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOHAMED TANANA (MEMBER)
(734) 469-2931
Entity
Organization
Contact information
Practice address
28370 JOY RD, LIVONIA, MI 48150-4133
(734) 469-2930
(734) 469-2929
Mailing address
28370 JOY RD, LIVONIA, MI 48150-4133
(734) 469-2930
(734) 469-2929
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
5301011110
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851831036
—
MI
01
—
2168098
PK
—
Enumeration date
03/07/2017
Last updated
04/19/2018
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