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General NPI Number Information
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NPI Number | 1316084338
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Entity Type | Organization
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Legal Business Name | AMANA PHARMACY
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 11/11/2010
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Provider Practice Location Address
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Address Line | 15343 W WARREN
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City | DEARBORN
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State | MI
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Zip | 48126
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Country | US
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Telephone | 313-584-0600
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Fax | 313-584-6462
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Provider Business Mailing Address
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Address Line | 15343 W WARREN
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City | DEARBORN
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State | MI
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Zip | 48126
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Country | US
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Telephone | 313-584-0600
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Fax | 313-584-6462
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Authorized Official
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Title or Position | OWNER
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Name | MR. EMAD A HAMDAN
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Credential |
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Telephone | 313-584-0600
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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 | 5301009158
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License Number State | MI
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