Healthcare Provider Details

I. General information

NPI: 1437477254
Provider Name (Legal Business Name): PHARMACY SPECIALIST, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2010
Last Update Date: 10/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14155 FARMINGTON RD
LIVONIA MI
48154-5422
US

IV. Provider business mailing address

14155 FARMINGTON RD
LIVONIA MI
48154-5422
US

V. Phone/Fax

Practice location:
  • Phone: 734-744-4844
  • Fax: 734-744-4847
Mailing address:
  • Phone: 734-744-4844
  • Fax: 734-744-4847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number5301009348
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MOJEEB SHAHBAIN
Title or Position: PHARMACIST
Credential: RPH.
Phone: 734-744-4844