Healthcare Provider Details

I. General information

NPI: 1407185002
Provider Name (Legal Business Name): UNITED PHARMACY ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2009
Last Update Date: 01/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5727 INKSTER RD
GARDEN CITY MI
48135-2960
US

IV. Provider business mailing address

5727 INKSTER RD
GARDEN CITY MI
48135-2960
US

V. Phone/Fax

Practice location:
  • Phone: 734-422-0788
  • Fax: 734-422-0795
Mailing address:
  • Phone: 734-422-0788
  • Fax: 734-422-0795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number5301009278
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NAGHAM FARAJ
Title or Position: CEO
Credential:
Phone: 313-820-9693