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General NPI Number Information
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NPI Number | 1639491574
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Entity Type | Organization
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Legal Business Name | ARBOR LANE PHARMACY AT FOX RUN INC.
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Dates
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Enumeration Date | 02/19/2010
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 41100 FOX RUN
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City | NOVI
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State | MI
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Zip | 48377-4804
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Country | US
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Telephone | 248-668-8778
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Fax | 248-668-8769
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Provider Business Mailing Address
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Address Line | 26423 DOXTATOR ST
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-3396
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Country | US
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Telephone | 313-999-2249
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Fax | 248-668-8769
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Authorized Official
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Title or Position | OWNER
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Name | ALEX FAKIH
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Credential |
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Telephone | 248-668-8778
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301009289
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License Number State | MI
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