Healthcare Provider Details

I. General information

NPI: 1295874246
Provider Name (Legal Business Name): TAYLOR DISCOUNT PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 12/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9320 TELEGRAPH RD
TAYLOR MI
48180-3362
US

IV. Provider business mailing address

9320 TELEGRAPH RD
TAYLOR MI
48180-3362
US

V. Phone/Fax

Practice location:
  • Phone: 313-299-8810
  • Fax: 313-299-8803
Mailing address:
  • Phone: 313-299-8810
  • Fax: 313-299-8803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301008574
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NAJMUDDEAN MOHAMED MURSHED
Title or Position: PIC
Credential: RPH
Phone: 313-299-8810