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General NPI Number Information
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NPI Number | 1104397843
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Entity Type | Organization
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Legal Business Name | HEALTHCENTER PHARMACY, LLC
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Dates
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Enumeration Date | 12/06/2018
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 21600 HARPER AVE STE 300
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-2242
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Country | US
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Telephone | 586-421-4003
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Fax | 586-421-4654
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Provider Business Mailing Address
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Address Line | 21600 HARPER AVE STE 300
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-2242
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Country | US
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Telephone | 586-421-4003
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Fax | 586-421-4654
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Authorized Official
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Title or Position | PHARMACIST/PIC
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Name | DR. MUSTAFA M HAIDAR
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Credential | PHARMD
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Telephone | 586-421-4003
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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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