Organization
ARBOR LAKES PHARMACY LLC
Active
Other names
Arbor Lakes Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NASHWAN ALGUMAEI RPH (OWNER, PIC, AO)
(734) 340-6050
Entity
Organization
Contact information
Practice address
1549 HOLMES RD, YPSILANTI, MI 48198-4147
(734) 340-6050
(734) 544-1337
Mailing address
1549 HOLMES RD, YPSILANTI, MI 48198-4147
(734) 340-6050
(734) 544-1337
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010767
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932574977
—
MI
01
—
2155831
PK
—
Enumeration date
12/02/2015
Last updated
05/19/2016
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