Healthcare Provider Details

I. General information

NPI: 1689820607
Provider Name (Legal Business Name): ZMC PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2008
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 S MAIN ST
ROYAL OAK MI
48067-3274
US

IV. Provider business mailing address

1041 S MAIN ST
ROYAL OAK MI
48067-3274
US

V. Phone/Fax

Practice location:
  • Phone: 248-280-6401
  • Fax: 248-280-6411
Mailing address:
  • Phone: 248-280-6401
  • Fax: 248-280-6411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301008889
License Number StateMI

VIII. Authorized Official

Name: JALAL ZAWAIDEH
Title or Position: PHARMACIST
Credential: PHARM.D.
Phone: 248-280-6401