Organization
DISCOUNT RX-PORT HURON LLC
Active
Other names
DISCOUNT RX-PORT HURON LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KHAJA A.F MOHAMMED (OWNER)
(810) 423-4433
Entity
Organization
Contact information
Practice address
4 N ORTONVILLE RD STE B, ORTONVILLE, MI 48462-8693
(248) 831-1222
(888) 821-2293
Mailing address
4 N ORTONVILLE RD STE B, ORTONVILLE, MI 48462-8693
(248) 831-1222
(888) 821-2293
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301011021
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166058
PK
—
05
—
2382682
—
MI
Enumeration date
11/03/2016
Last updated
03/13/2020
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