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General NPI Number Information
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NPI Number | 1043109259
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Entity Type | Organization
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Legal Business Name | CENTER STREET PHARMACY PLLC
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 156 N CENTER ST STE 103
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City | NORTHVILLE
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State | MI
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Zip | 48167-1489
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Country | US
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Telephone | 734-846-8569
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Fax |
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Provider Business Mailing Address
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Address Line | 43347 RIVERBRIDGE CT
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City | NOVI
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State | MI
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Zip | 48375-4722
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Country | US
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Telephone | 313-675-9516
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MOHAMED ALI SANEH
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Credential |
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Telephone | 734-846-8569
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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