Organization
SOBH RX LLC
Active
Other names
Park Place Pharmacy of Taylor
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMAD SOBH (PIC/OFFICER)
(313) 622-0432
Entity
Organization
Contact information
Practice address
12701 TELEGRAPH RD, STE 101A, TAYLOR, MI 48180-6847
(734) 225-8010
(734) 225-8011
Mailing address
6767 WHITEFIELD ST, DEARBORN HEIGHTS, MI 48127-4711
(313) 622-0432
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301008973
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2371906
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/02/2008
Last updated
12/22/2010
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