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General NPI Number Information
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NPI Number | 1679041909
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Entity Type | Organization
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Legal Business Name | CADIEUX DISCOUNT PHARMACY LLC
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Dates
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Enumeration Date | 11/05/2018
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Last Update Date | 09/25/2019
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Provider Practice Location Address
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Address Line | 17163 HARPER AVE
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City | DETROIT
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State | MI
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Zip | 48224-1904
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Country | US
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Telephone | 313-485-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 17163 HARPER AVE
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City | DETROIT
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State | MI
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Zip | 48224-1904
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Country | US
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Telephone | 313-499-1110
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Fax |
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Authorized Official
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Title or Position | PIC
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Name | AHMAD KAID
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Credential |
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Telephone | 313-499-1110
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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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