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General NPI Number Information
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NPI Number | 1245324656
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Entity Type | Organization
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Legal Business Name | FA ENTERPRISES INC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 15101 SOUTHFIELD RD STE 101
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City | ALLEN PARK
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State | MI
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Zip | 48101-2697
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Country | US
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Telephone | 313-928-4922
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Fax | 313-928-4923
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Provider Business Mailing Address
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Address Line | 15101 SOUTHFIELD RD STE 101
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City | ALLEN PARK
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State | MI
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Zip | 48101-2697
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Country | US
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Telephone | 313-928-4922
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Fax | 313-928-4923
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | NUMAN ALI-AHMED
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Credential | RPH
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Telephone | 313-928-4922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301007798
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License Number State | MI
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