Healthcare Provider Details

I. General information

NPI: 1811269046
Provider Name (Legal Business Name): MEDCART LTC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2012
Last Update Date: 01/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32131 INDUSTRIAL RD
LIVONIA MI
48150-1836
US

IV. Provider business mailing address

32131 INDUSTRIAL RD
LIVONIA MI
48150-1836
US

V. Phone/Fax

Practice location:
  • Phone: 734-762-6600
  • Fax:
Mailing address:
  • Phone: 734-762-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number5301009397
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: EMAD SALEH
Title or Position: SECRETARY
Credential:
Phone: 313-414-7170