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General NPI Number Information
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NPI Number | 1538735121
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Entity Type | Organization
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Legal Business Name | BLUESTONE PHARMACY LLC
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Dates
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Enumeration Date | 06/03/2021
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Last Update Date | 06/03/2021
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Provider Practice Location Address
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Address Line | 13469 E 14 MILE RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48312-6304
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Country | US
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Telephone | 313-445-0058
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Fax |
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Provider Business Mailing Address
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Address Line | 5294 BINGHAM ST
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City | DEARBORN
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State | MI
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Zip | 48126-3304
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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 IN CHARGE
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Name | MAJDI ALHUSSEINI
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Credential |
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Telephone | 313-445-0058
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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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