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General NPI Number Information
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NPI Number | 1528670791
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Entity Type | Organization
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Legal Business Name | COUNTY PHARMACY LLC
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Dates
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Enumeration Date | 08/19/2020
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Last Update Date | 04/26/2021
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Provider Practice Location Address
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Address Line | 233 W CARLETON RD
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City | HILLSDALE
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State | MI
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Zip | 49242-5033
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Country | US
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Telephone | 313-595-6940
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Fax |
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Provider Business Mailing Address
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Address Line | 233 W CARLETON RD
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City | HILLSDALE
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State | MI
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Zip | 49242-5033
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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 | PHARMACIST
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Name | MOHAMED A BEYDOUN
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Credential | PHARMD
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Telephone | 517-610-5665
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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 |
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License Number State |
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