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General NPI Number Information
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NPI Number | 1881112555
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Entity Type | Organization
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Legal Business Name | PURRXPHARMACY
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Dates
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Enumeration Date | 09/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 38300 VAN DYKE AVE STE 102
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City | STERLING HEIGHTS
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State | MI
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Zip | 48312-1176
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Country | US
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Telephone | 844-714-1207
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Fax | 844-714-1208
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Provider Business Mailing Address
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Address Line | 38300 VAN DYKE AVE STE 102
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City | STERLING HEIGHTS
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State | MI
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Zip | 48312-1176
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Country | US
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Telephone | 844-714-1207
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Fax | 844-714-1208
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Authorized Official
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Title or Position | OWNER
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Name | MR. EYAD KHADR
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Credential |
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Telephone | 844-714-1207
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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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