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General NPI Number Information
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NPI Number | 1356992317
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Entity Type | Organization
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Legal Business Name | MONAS PHARMACY LLC
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Dates
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Enumeration Date | 09/21/2019
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Last Update Date | 09/21/2019
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Provider Practice Location Address
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Address Line | 15031 EUREKA RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-2609
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Country | US
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Telephone | 734-285-1740
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Fax |
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Provider Business Mailing Address
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Address Line | 15031 EUREKA RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-2609
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MONA NABHA
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Credential |
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Telephone | 313-942-7611
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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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