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General NPI Number Information
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NPI Number | 1750841292
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Entity Type | Organization
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Legal Business Name | PHARMACONSULTANT LLC
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 03/21/2019
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Provider Practice Location Address
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Address Line | 627 S GULLEY RD
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City | DEARBORN
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State | MI
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Zip | 48124-1235
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Country | US
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Telephone | 313-595-4108
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Fax |
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Provider Business Mailing Address
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Address Line | 627 S GULLEY RD
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City | DEARBORN
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State | MI
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Zip | 48124-1235
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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 | CO-OWNER
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Name | ZEINA BERRY
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Credential |
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Telephone | 313-595-4108
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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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