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General NPI Number Information
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NPI Number | 1205741154
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Entity Type | Organization
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Legal Business Name | PANACEA RX GROUP LLC
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Dates
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Enumeration Date | 08/17/2026
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | 1650 MONROE ST
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City | DEARBORN
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State | MI
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Zip | 48124-2913
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Country | US
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Telephone | 313-948-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 MONROE ST
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City | DEARBORN
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State | MI
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Zip | 48124-2913
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Country | US
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Telephone | 313-948-8888
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JABER ALJAHMI
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Credential |
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Telephone | 313-948-8888
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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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