Healthcare Provider Details

I. General information

NPI: 1255069076
Provider Name (Legal Business Name): YEMEN CARE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9222 JOSEPH CAMPAU ST
HAMTRAMCK MI
48212-4059
US

IV. Provider business mailing address

9222 JOSEPH CAMPAU ST
HAMTRAMCK MI
48212-4059
US

V. Phone/Fax

Practice location:
  • Phone: 313-558-2121
  • Fax: 313-558-2020
Mailing address:
  • Phone: 313-558-2121
  • Fax: 313-558-2020

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: BAKEAL ABDO ELJAHMI
Title or Position: OWNER
Credential:
Phone: 313-558-2121