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General NPI Number Information
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NPI Number | 1386403194
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Entity Type | Organization
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Legal Business Name | CENTRAL PHARMACY - MAPLE VALLEY LLC
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Dates
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Enumeration Date | 03/14/2024
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Last Update Date | 03/14/2024
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Provider Practice Location Address
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Address Line | 219 N MAIN ST
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City | NASHVILLE
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State | MI
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Zip | 49073-9577
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Country | US
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Telephone | 517-615-4700
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Fax |
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Provider Business Mailing Address
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Address Line | 219 N MAIN ST
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City | NASHVILLE
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State | MI
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Zip | 49073-9577
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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 | OFFICER
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Name | AHMED SHERIF HOSSAM SAID
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Credential |
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Telephone | 313-405-2375
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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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Taxonomy #2
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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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