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General NPI Number Information
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NPI Number | 1972812030
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Entity Type | Organization
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Legal Business Name | VILLAGE RX
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Dates
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Enumeration Date | 10/06/2010
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 7910 SCHAEFER RD
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City | DEARBORN
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State | MI
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Zip | 48126-1161
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Country | US
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Telephone | 313-581-5272
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Fax | 313-769-6316
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Provider Business Mailing Address
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Address Line | 7910 SCHAEFER RD
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City | DEARBORN
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State | MI
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Zip | 48126-1161
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Country | US
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Telephone | 313-581-5272
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Fax | 313-769-6316
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Authorized Official
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Title or Position | OWNER
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Name | BELAL ABDALLAH
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Credential |
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Telephone | 313-581-5272
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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 | 5301009430
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License Number State | MI
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