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General NPI Number Information
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NPI Number | 1043482243
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Entity Type | Organization
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Legal Business Name | MOTOR CITY PHARMACY CORP
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 20526 PLYMOUTH RD SUITE D
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City | DETROIT
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State | MI
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Zip | 48228-1201
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Country | US
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Telephone | 313-838-2555
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Fax | 313-838-1320
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Provider Business Mailing Address
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Address Line | 20526 PLYMOUTH RD SUITE D
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City | DETROIT
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State | MI
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Zip | 48228-1201
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Country | US
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Telephone | 313-838-2555
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Fax | 313-838-1320
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Authorized Official
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Title or Position | PRESIDENT/PHARMACIST
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Name | MRS. SUZAN BERRY FADLALLAH
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Credential | RPH
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Telephone | 313-838-2555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301005113
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License Number State | MI
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