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NPI 1164082103

NPI 1164082103 : WRIGLEY'S PHARMACY 4, LLC : DETROIT, MI

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General NPI Number Information
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    NPI Number           |    1164082103
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    Entity Type          |    Organization 
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    Legal Business Name  |    WRIGLEY'S PHARMACY 4, LLC 
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Dates
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    Enumeration Date     |    06/20/2019
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    Last Update Date     |    09/15/2025
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Provider Practice Location Address
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    Address Line         |    14313 GREENFIELD RD 
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    City                 |    DETROIT
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    State                |    MI
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    Zip                  |    48227-2107
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    Country              |    US
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    Telephone            |    313-969-3668
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 927 
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    City                 |    DEARBORN
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    State                |    MI
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    Zip                  |    48121-0927
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MEMBER
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    Name                 |     HASSEN  SAAD 
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    Credential           |    
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    Telephone            |    313-598-3031
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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       |    
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    License Number State |    
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