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General NPI Number Information
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NPI Number | 1396182978
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Entity Type | Organization
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Legal Business Name | HEIGHTS INKSTER PHARMACY INC
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Dates
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Enumeration Date | 05/23/2013
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Last Update Date | 05/23/2013
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Provider Practice Location Address
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Address Line | 349 INKSTER RD
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City | INKSTER
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State | MI
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Zip | 48141-1208
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Country | US
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Telephone | 313-563-5325
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Fax | 734-391-8231
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Provider Business Mailing Address
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Address Line | 349 INKSTER RD
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City | INKSTER
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State | MI
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Zip | 48141-1208
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Country | US
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Telephone | 313-563-5325
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Fax | 734-391-8231
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Authorized Official
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Title or Position | PRESIDENT
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Name | NAZIHA BAYDOUN
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Credential |
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Telephone | 313-485-1311
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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 | 5301010107
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License Number State | MI
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