MEDICARE: FRANKLIN MEDICAL PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0002X	Clinic Pharmacy
2	3336C0004X	Compounding Pharmacy
3	3336C0003X	Community/Retail Pharmacy	5301009132	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2366602	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1053351908
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRANKLIN MEDICAL PHARMACY INC

Provider Business Mailing Address
First Line	:	17950 WOODWARD AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48203-2260
Country	:	US
Telephone Number	:	313-866-4660
Fax Number	:	313-866-4662

Provider Business Practice Location Address
First Line	:	17950 WOODWARD AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48203-2260
Country	:	US
Telephone Number	:	313-866-4660
Fax Number	:	313-866-4662

Authorized Official
Title or Position	:	OWNER
Name	:	ALI FAKIH
Credential	:
Telephone Number	:	313-866-4660

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	05/03/2010

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Directions to “FRANKLIN MEDICAL PHARMACY INC ” Practice Location

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