Healthcare Provider Details

I. General information

NPI: 1336304567
Provider Name (Legal Business Name): AMINE AND ASSOCIATES GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 09/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20746 MACK AVE
GROSSE POINTE WOODS MI
48236-1436
US

IV. Provider business mailing address

20746 MACK AVE
GROSSE POINTE WOODS MI
48236-1436
US

V. Phone/Fax

Practice location:
  • Phone: 313-640-9766
  • Fax: 313-640-9768
Mailing address:
  • Phone: 313-640-9766
  • Fax: 313-640-9768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301008890
License Number StateMI

VIII. Authorized Official

Name: ABDULLA SHARIFF
Title or Position: PRESIDENT
Credential: BSC PHARM
Phone: 313-258-6660