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General NPI Number Information
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NPI Number | 1114284247
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Entity Type | Organization
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Legal Business Name | MEDSMART PHARMACY LLC
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 04/13/2012
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Provider Practice Location Address
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Address Line | 27101 SCHOENHERR RD STE 100
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City | WARREN
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State | MI
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Zip | 48088-4730
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Country | US
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Telephone | 586-298-6796
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Fax |
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Provider Business Mailing Address
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Address Line | 27101 SCHOENHERR RD SUITE 100
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City | WARREN
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State | MI
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Zip | 48088-4730
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Country | US
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Telephone | 586-298-6796
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | EMAD SALEH
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Credential |
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Telephone | 313-414-7170
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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 | 5301009782
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License Number State | MI
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