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General NPI Number Information
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NPI Number | 1386964203
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Entity Type | Organization
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Legal Business Name | ROYAL OAK FAMILY PHARMACY, LLC
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Dates
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Enumeration Date | 06/02/2010
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Last Update Date | 10/20/2014
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Provider Practice Location Address
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Address Line | 23420 WOODWARD AVE
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City | FERNDALE
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State | MI
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Zip | 48220-1344
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Country | US
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Telephone | 248-336-2677
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Fax |
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Provider Business Mailing Address
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Address Line | 23420 WOODWARD AVE
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City | FERNDALE
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State | MI
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Zip | 48220-1344
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Country | US
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Telephone | 248-336-2677
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/PHARMACY MANAGER
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Name | MR. AIMAN RABIH KAWAS
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Credential | RPH
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Telephone | 313-657-1630
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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 | 5301009267
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301009267
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License Number State | MI
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