Healthcare Provider Details

I. General information

NPI: 1902739949
Provider Name (Legal Business Name): MTM COMMUNITY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35150 NANKIN BLVD
WESTLAND MI
48185-2091
US

IV. Provider business mailing address

35150 NANKIN BLVD
WESTLAND MI
48185-2091
US

V. Phone/Fax

Practice location:
  • Phone: 313-888-1140
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: IBRAHIM SHARIFF
Title or Position: OWNER
Credential:
Phone: 313-888-1140