Healthcare Provider Details
I. General information
NPI: 1750808564
Provider Name (Legal Business Name): MAPLEVIEW PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/23/2017
Last Update Date: 10/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
35200 DEQUINDRE RD SUITE # 200
STERLING HEIGHTS MI
48310
US
IV. Provider business mailing address
35200 DEQUINDRE RD STE 200
STERLING HEIGHTS MI
48310-4837
US
V. Phone/Fax
- Phone: 586-270-5000
- Fax: 586-270-5001
- Phone: 586-270-5000
- Fax: 586-270-5001
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
MUHAMMAD
RAMZAN
Title or Position: PHARMACY MANAGER
Credential: RPH
Phone: 586-270-5000