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General NPI Number Information
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NPI Number | 1205260841
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Entity Type | Organization
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Legal Business Name | JOHN R EXPRESS PHARMACY PC
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Dates
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Enumeration Date | 08/31/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 26100 JOHN R RD
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-3648
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Country | US
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Telephone | 248-268-3302
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Fax | 248-268-3317
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Provider Business Mailing Address
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Address Line | 26100 JOHN R RD
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-3648
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Country | US
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Telephone | 248-268-3302
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Fax | 248-268-3317
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Authorized Official
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Title or Position | OWNER
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Name | HASHAM JADALLAH
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Credential |
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Telephone | 248-268-3302
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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 | MI
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