Healthcare Provider Details

I. General information

NPI: 1144524653
Provider Name (Legal Business Name): CARE PLUS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2010
Last Update Date: 03/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14847 GRATIOT AVE
DETROIT MI
48205-1942
US

IV. Provider business mailing address

14847 GRATIOT AVE
DETROIT MI
48205-1942
US

V. Phone/Fax

Practice location:
  • Phone: 313-332-0575
  • Fax: 313-469-0212
Mailing address:
  • Phone: 313-332-0575
  • Fax: 313-469-0212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number5301009461
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MOHAMAD HAMADE
Title or Position: OWNER
Credential: RPH
Phone: 313-258-1102