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General NPI Number Information
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NPI Number | 1124488168
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Entity Type | Organization
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Legal Business Name | AYAMA CORP
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 26795 JOHN R ROAD SUITE B
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071
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Country | US
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Telephone | 248-268-1102
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Fax | 248-268-1121
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Provider Business Mailing Address
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Address Line | 26795 JOHN R ROAD SUITE B
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071
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Country | US
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Telephone | 248-268-1102
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Fax | 248-268-1121
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. A YOUSAF
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Credential | RPH
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Telephone | 248-268-1102
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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 | 5301010878
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License Number State | MI
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