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General NPI Number Information
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NPI Number | 1194253195
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Entity Type | Organization
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Legal Business Name | R K PHARMACY INC
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Dates
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Enumeration Date | 06/02/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 181 N WAYNE RD
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City | WESTLAND
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State | MI
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Zip | 48185-3624
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Country | US
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Telephone | 734-589-0400
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Fax | 734-329-5460
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Provider Business Mailing Address
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Address Line | 181 N WAYNE RD
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City | WESTLAND
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State | MI
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Zip | 48185-3624
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Country | US
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Telephone | 734-589-0400
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Fax | 734-329-5460
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Authorized Official
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Title or Position | PHARMACY OWNER/PHARMACIST IN CHARGE
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Name | MR. KHODR M BAZZI
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Credential | PHARMACIST
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Telephone | 313-414-5507
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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 | 5301011186
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License Number State | MI
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