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General NPI Number Information
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NPI Number | 1013729037
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Entity Type | Organization
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Legal Business Name | PURE AID LLC
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Dates
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Enumeration Date | 01/25/2025
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Last Update Date | 01/25/2025
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Provider Practice Location Address
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Address Line | 1647 INKSTER RD STE D
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City | GARDEN CITY
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State | MI
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Zip | 48135-3086
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Country | US
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Telephone | 734-742-5686
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Fax | 734-742-5683
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Provider Business Mailing Address
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Address Line | 1647 INKSTER RD STE D
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City | GARDEN CITY
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State | MI
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Zip | 48135-3086
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Country | US
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Telephone | 734-742-5686
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Fax | 734-742-5683
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | DR. SAFA JABER
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Credential | PHARMD
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Telephone | 313-655-2118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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