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General NPI Number Information
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NPI Number | 1427578483
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Entity Type | Organization
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Legal Business Name | ELWASEEM & ASSOCIATES LLC
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 02/01/2018
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Provider Practice Location Address
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Address Line | 4208 E 9 MILE RD
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City | WARREN
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State | MI
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Zip | 48091-2578
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Country | US
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Telephone | 586-806-2060
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Fax | 586-806-2063
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Provider Business Mailing Address
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Address Line | 4208 E 9 MILE RD
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City | WARREN
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State | MI
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Zip | 48091-2578
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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 | OWNER
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Name | AHMED ELWASEEM
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Credential | PHARMD
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Telephone | 313-231-4432
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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 | 5301011185
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License Number State | MI
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