Healthcare Provider Details

I. General information

NPI: 1013189422
Provider Name (Legal Business Name): SIGMAPHARM CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 07/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 W VERNOR HWY
DETROIT MI
48209-1522
US

IV. Provider business mailing address

8040 W VERNOR HWY
DETROIT MI
48209-1522
US

V. Phone/Fax

Practice location:
  • Phone: 313-297-3550
  • Fax: 313-297-3552
Mailing address:
  • Phone: 877-540-4748
  • Fax: 801-716-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301007886
License Number StateMI

VIII. Authorized Official

Name: EMAD SALEH
Title or Position: OFFICER
Credential: RPH
Phone: 313-297-3550