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NPI Code Detail

MEDICARE: MINAL PHARMACY LLC

MEDICARE: MINAL PHARMACY 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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy5301009260MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12123205OTHERPK

General Provider Information

NPI Number : 1790014819
Entity Type Code : Organization
Provider Name (Legal Business Name) : MINAL PHARMACY LLC
Provider Business Mailing Address
First Line : 13031 CONANT ST
Second Line :
City : DETROIT
State : MI
Zip : 48212-2361
Country : US
Telephone Number : 313-893-3339
Fax Number : 313-893-3337
Provider Business Practice Location Address
First Line : 13031 CONANT ST
Second Line :
City : DETROIT
State : MI
Zip : 48212-2361
Country : US
Telephone Number : 313-893-3339
Fax Number : 313-893-3337
Authorized Official
Title or Position : OWNER, PIC,R.PH
Name : SYED SAEED
Credential :
Telephone Number : 586-764-3302
Provider Enumeration Date : 12/19/2009
Last Update Date : 09/01/2015

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Directions to “MINAL PHARMACY LLC ” Practice Location

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