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General NPI Number Information
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NPI Number | 1679614044
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Entity Type | Organization
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Legal Business Name | KAKISH PLARMACY INC.
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5050 SCHAEFER RD
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City | DEARBORN
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State | MI
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Zip | 48126-3249
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Country | US
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Telephone | 313-582-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 5050 SCHAEFER RD
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City | DEARBORN
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State | MI
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Zip | 48126-3249
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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 | PRESIDENT
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Name | JAMAL S KAKISH
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Credential |
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Telephone | 313-582-0100
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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 | 5301003631
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License Number State | MI
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