Healthcare Provider Details

I. General information

NPI: 1952232456
Provider Name (Legal Business Name): AVENUE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24706 MICHIGAN AVE STE D
DEARBORN MI
48124-1750
US

IV. Provider business mailing address

130 N YORK ST
DEARBORN MI
48128-1746
US

V. Phone/Fax

Practice location:
  • Phone: 313-515-6422
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: HASSAN CHAMI
Title or Position: OWNER
Credential: PHARMD
Phone: 313-515-6422