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General NPI Number Information
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NPI Number | 1285426056
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Entity Type | Organization
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Legal Business Name | TLC PHARMACY INC
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 2959 S TELEGRAPH RD
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City | DEARBORN
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State | MI
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Zip | 48124-3241
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Country | US
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Telephone | 313-274-0800
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Fax | 313-274-7788
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Provider Business Mailing Address
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Address Line | 2959 S TELEGRAPH RD
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City | DEARBORN
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State | MI
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Zip | 48124-3241
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Country | US
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Telephone | 313-274-0800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALIDAH NATHOO
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Credential | RPH
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Telephone | 313-274-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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