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General NPI Number Information
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NPI Number | 1871641878
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Entity Type | Organization
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Legal Business Name | ALLEGAN PHARMACY LLC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 10/22/2023
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Provider Practice Location Address
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Address Line | 551 LINN ST STE120
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City | ALLEGAN
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State | MI
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Zip | 49010
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Country | US
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Telephone | 269-673-4700
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Fax | 269-673-4711
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Provider Business Mailing Address
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Address Line | 551 LINN ST STE120
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City | ALLEGAN
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State | MI
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Zip | 49010
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Country | US
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Telephone | 269-673-4700
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Fax | 269-673-4711
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Authorized Official
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Title or Position | OWNER
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Name | MR. MOHAMED ALI BEYDOUN
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Credential | PHARM D
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Telephone | 313-378-1938
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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 | 5301008560
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License Number State | MI
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