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General NPI Number Information
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NPI Number | 1063820512
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Entity Type | Organization
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Legal Business Name | VILLA LINDE PHARMACY, LLC
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Dates
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Enumeration Date | 07/29/2014
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 1260 S LINDEN RD
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City | FLINT
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State | MI
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Zip | 48532-3407
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Country | US
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Telephone | 810-820-9855
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Fax | 810-720-3899
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Provider Business Mailing Address
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Address Line | 1260 S LINDEN RD
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City | FLINT
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State | MI
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Zip | 48532-3407
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Country | US
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Telephone | 810-820-9855
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Fax | 810-720-3899
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Authorized Official
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Title or Position | OWNER/PIC
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Name | OMAR ATTAR
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Credential |
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Telephone | 810-820-9855
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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 | 5301010507
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License Number State | MI
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