Healthcare Provider Details

I. General information

NPI: 1588592604
Provider Name (Legal Business Name): MAHA PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8286 E 12 MILE RD
WARREN MI
48093-2737
US

IV. Provider business mailing address

8286 E 12 MILE RD
WARREN MI
48093-2737
US

V. Phone/Fax

Practice location:
  • Phone: 586-238-0277
  • Fax: 586-619-7818
Mailing address:
  • Phone: 586-238-0277
  • Fax: 586-619-7818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TAHIRA SANAULLAH
Title or Position: PRESIDENT
Credential: RPH
Phone: 248-835-6552