Healthcare Provider Details

I. General information

NPI: 1447140306
Provider Name (Legal Business Name): NOBLE CARE APOTHECARY 2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 UNION LAKE RD STE 213
COMMERCE TOWNSHIP MI
48382-3526
US

IV. Provider business mailing address

2900 UNION LAKE RD STE 213
COMMERCE TWP MI
48382-3526
US

V. Phone/Fax

Practice location:
  • Phone: 248-461-6509
  • Fax: 248-599-9266
Mailing address:
  • Phone: 947-267-2455
  • Fax: 947-252-7373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. SHATHA MATTI
Title or Position: PHARMACIST IN CHARGE/OWNER
Credential: PHARMD
Phone: 947-267-2455