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General NPI Number Information
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NPI Number | 1821354168
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Entity Type | Organization
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Legal Business Name | AZAAL DISCOUNT PHARMACY INC
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Dates
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Enumeration Date | 04/11/2012
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Last Update Date | 07/13/2016
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Provider Practice Location Address
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Address Line | 9834 CONANT ST
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City | HAMTRAMCK
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State | MI
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Zip | 48212-3309
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Country | US
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Telephone | 313-872-0021
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Fax | 313-872-0037
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Provider Business Mailing Address
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Address Line | 9834 CONANT ST
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City | HAMTRAMCK
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State | MI
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Zip | 48212-3309
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Country | US
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Telephone | 313-872-0021
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Fax | 313-872-0037
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | BANDAR SALEH
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Credential |
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Telephone | 313-872-0021
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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 | 5301009821
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License Number State | MI
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