Healthcare Provider Details

I. General information

NPI: 1902982697
Provider Name (Legal Business Name): SMIDI DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23032 E MAIN ST
ARMADA MI
48005-4705
US

IV. Provider business mailing address

23032 E MAIN ST P O BOX 901
ARMADA MI
48005-4705
US

V. Phone/Fax

Practice location:
  • Phone: 586-784-9222
  • Fax: 586-784-8864
Mailing address:
  • Phone: 586-784-9222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301008796
License Number StateMI

VIII. Authorized Official

Name: HUSSEIN SMIDI
Title or Position: OWNER
Credential: RPH
Phone: 586-784-9222