Healthcare Provider Details

I. General information

NPI: 1790059525
Provider Name (Legal Business Name): PICK ME UP NOW, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2012
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32778 RYAN RD
WARREN MI
48092-1112
US

IV. Provider business mailing address

32778 RYAN RD
WARREN MI
48092-1112
US

V. Phone/Fax

Practice location:
  • Phone: 586-254-6446
  • Fax:
Mailing address:
  • Phone: 586-254-6446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License NumberD6695Q
License Number StateMI

VIII. Authorized Official

Name: MR. MUSHTAQ AL-NAJJAR
Title or Position: PRESIDENT
Credential:
Phone: 586-254-6446