Healthcare Provider Details

I. General information

NPI: 1235854852
Provider Name (Legal Business Name): BUENA SALUD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2022
Last Update Date: 10/06/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7607 W VERNOR HWY
DETROIT MI
48209-1513
US

IV. Provider business mailing address

7607 W VERNOR HWY
DETROIT MI
48209-1513
US

V. Phone/Fax

Practice location:
  • Phone: 313-724-7555
  • Fax: 313-724-7556
Mailing address:
  • Phone: 313-724-7555
  • Fax: 313-724-7556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SAHER ABDULMALEK
Title or Position: OWNER
Credential:
Phone: 313-674-5968