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General NPI Number Information
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NPI Number | 1881857639
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Entity Type | Organization
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Legal Business Name | SOBH RX LLC
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 12/22/2010
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Provider Practice Location Address
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Address Line | 12701 TELEGRAPH RD STE 101A
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City | TAYLOR
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State | MI
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Zip | 48180-6847
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Country | US
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Telephone | 734-225-8010
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Fax | 734-225-8011
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Provider Business Mailing Address
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Address Line | 6767 WHITEFIELD ST
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-4711
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Country | US
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Telephone | 313-622-0432
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Fax |
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Authorized Official
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Title or Position | PIC/OFFICER
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Name | MOHAMAD SOBH
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Credential |
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Telephone | 313-622-0432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301008973
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License Number State | MI
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