Healthcare Provider Details

I. General information

NPI: 1790135671
Provider Name (Legal Business Name): PHARMACHOICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2016
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15635 W WARREN AVE
DETROIT MI
48228-3733
US

IV. Provider business mailing address

15635 W WARREN AVE
DETROIT MI
48228-3733
US

V. Phone/Fax

Practice location:
  • Phone: 313-581-6000
  • Fax: 313-581-6600
Mailing address:
  • Phone: 313-581-6000
  • Fax: 313-581-6600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number5301011040
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number5301011040
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: FAHMAN ABDO ELMATHIL
Title or Position: OWNER
Credential:
Phone: 313-581-6000