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General NPI Number Information
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NPI Number | 1558039222
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Entity Type | Organization
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Legal Business Name | PARADISE PHARMACY, LLC
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 13031 CONANT ST
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City | DETROIT
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State | MI
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Zip | 48212-2361
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Country | US
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Telephone | 313-893-3339
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Fax | 313-893-3337
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Provider Business Mailing Address
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Address Line | 13031 CONANT ST
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City | DETROIT
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State | MI
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Zip | 48212-2361
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Country | US
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Telephone | 313-893-3339
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Fax | 313-893-3337
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Authorized Official
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Title or Position | OWNER
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Name | MR. FAHAD NAEEM
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Credential |
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Telephone | 586-554-3787
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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 |
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License Number State |
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