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General NPI Number Information
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NPI Number | 1851831036
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Entity Type | Organization
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Legal Business Name | QUALICARE RX, LLC
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Dates
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Enumeration Date | 03/07/2017
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Last Update Date | 04/19/2018
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Provider Practice Location Address
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Address Line | 28370 JOY RD
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City | LIVONIA
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State | MI
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Zip | 48150-4133
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Country | US
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Telephone | 734-469-2930
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Fax | 734-469-2929
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Provider Business Mailing Address
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Address Line | 28370 JOY RD
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City | LIVONIA
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State | MI
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Zip | 48150-4133
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Country | US
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Telephone | 734-469-2930
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Fax | 734-469-2929
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Authorized Official
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Title or Position | MEMBER
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Name | MR. MOHAMED TANANA
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Credential |
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Telephone | 734-469-2931
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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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 5301011110
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License Number State | MI
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