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General NPI Number Information
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NPI Number | 1164437992
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Entity Type | Organization
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Legal Business Name | ROSA PARK MEDICAL PHARMACY LLC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 04/19/2018
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Provider Practice Location Address
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Address Line | 8665 ROSA PARKS BOULAVARD
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City | DETROIT
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State | MI
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Zip | 48206
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Country | US
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Telephone | 313-361-8800
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Fax | 313-361-8875
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Provider Business Mailing Address
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Address Line | 8665 ROSA PARKS BOULAVARD
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City | DETROIT
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State | MI
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Zip | 48206
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Country | US
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Telephone | 313-361-8800
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Fax | 313-361-8875
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Authorized Official
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Title or Position | PHARMACIST
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Name | AHMED SAID
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Credential | PHARMD
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Telephone | 313-377-8876
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301008435
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License Number State | MI
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