MEDICARE: OSMAN OSMAN

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0004X	Compounding Pharmacy
4	3336C0003X	Community/Retail Pharmacy	5301008343	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2368151	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1568411288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSMAN OSMAN

Provider Business Mailing Address
First Line	:	PO BOX 100
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48501-0100
Country	:	US
Telephone Number	:	810-239-8000
Fax Number	:	810-762-9004

Provider Business Practice Location Address
First Line	:	2700 LONGWAY BLVD
Second Line	:	SUITE B
City	:	FLINT
State	:	MI
Zip	:	48503-2190
Country	:	US
Telephone Number	:	810-239-8000
Fax Number	:	810-762-9004

Authorized Official
Title or Position	:	OWNER
Name	:	OSMAN OSMAN
Credential	:	RPH
Telephone Number	:	810-239-8000

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	12/17/2009

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Directions to “OSMAN OSMAN ” Practice Location

Language	Start Address	Practice Location

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