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General NPI Number Information
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NPI Number | 1053966036
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Entity Type | Organization
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Legal Business Name | SHEBA PHARMACY 2 LLC
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Dates
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Enumeration Date | 08/06/2019
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 4132 SCHAEFER RD
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City | DEARBORN
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State | MI
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Zip | 48126-3683
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Country | US
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Telephone | 313-258-6660
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Fax | 313-841-8846
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Provider Business Mailing Address
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Address Line | 4132 SCHAEFER RD
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City | DEARBORN
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State | MI
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Zip | 48126-3683
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Country | US
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Telephone | 313-258-6660
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Fax | 313-841-8846
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Authorized Official
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Title or Position | OWNER
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Name | MR. ABDULLA M SHARIFF
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Credential | RPH
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Telephone | 313-258-6660
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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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