Organization
BEYDOUN DRUG STORES PC
Active
Other names
Good Health Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WISSAM BEYDOUN (OWNER/PRESIDENT)
(313) 663-1050
Entity
Organization
Contact information
Practice address
13821 W 9 MILE RD, OAK PARK, MI 48237-2775
(248) 541-0600
(248) 541-0603
Mailing address
314 CENTRALIA ST, DEARBORN HTS, MI 48127-3740
(313) 663-1050
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009001
MI
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2118193
PK
—
Enumeration date
12/12/2008
Last updated
11/18/2016
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