MEDICARE: PHARM ADVISORS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	5301010714	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2153556	OTHER		PK

General Provider Information

NPI Number	:	1528434354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARM ADVISORS LLC

Provider Business Mailing Address
First Line	:	2074 S WAYNE RD
Second Line	:
City	:	WESTLAND
State	:	MI
Zip	:	48186-5428
Country	:	US
Telephone Number	:	734-728-5900
Fax Number	:	734-728-3519

Provider Business Practice Location Address
First Line	:	2074 S WAYNE RD
Second Line	:
City	:	WESTLAND
State	:	MI
Zip	:	48186-5428
Country	:	US
Telephone Number	:	734-728-5900
Fax Number	:	734-728-3519

Authorized Official
Title or Position	:	OWNER
Name	:	MOHAMAD CHARAF
Credential	:
Telephone Number	:	313-782-5590

Provider Enumeration Date	:	08/17/2015
Last Update Date	:	01/19/2017

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