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General NPI Number Information
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NPI Number | 1588151112
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Entity Type | Organization
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Legal Business Name | FOX HILLS MEDI-MART DISCOUNT DRUG CENTER INC
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 1821 N CAMPBELL RD
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City | ROYAL OAK
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State | MI
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Zip | 48073-4237
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Country | US
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Telephone | 248-858-2225
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Fax | 248-858-2527
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Provider Business Mailing Address
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Address Line | 1539 S OPDYKE RD
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48304-1042
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Country | US
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Telephone | 248-858-2225
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Fax | 248-858-2527
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Authorized Official
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Title or Position | PRESIDENT
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Name | WESSAM YOUSEF
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Credential |
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Telephone | 248-858-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 5301003021
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License Number State | MI
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