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General NPI Number Information
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NPI Number | 1366759300
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Entity Type | Organization
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Legal Business Name | JCMA PHARMACY INC
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Dates
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Enumeration Date | 09/13/2010
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 8623 N WAYNE RD STE 101
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City | WESTLAND
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State | MI
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Zip | 48185-1137
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Country | US
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Telephone | 734-523-6500
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Fax | 734-523-6504
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Provider Business Mailing Address
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Address Line | 43155 W 9 MILE RD
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City | NOVI
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State | MI
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Zip | 48375-4190
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Country | US
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Telephone | 248-348-1570
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Fax | 248-348-4316
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Authorized Official
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Title or Position | OWNER
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Name | HUSSEIN ELSAGHIR
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Credential |
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Telephone | 734-523-6500
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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 | 5301009410
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License Number State | MI
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