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NPI Code Detail

MEDICARE: MIDTOWN RX PHARMACY INC

MEDICARE: MIDTOWN RX 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
13336C0003XCommunity/Retail Pharmacy5301010730MI

General Provider Information

NPI Number : 1407223803
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIDTOWN RX PHARMACY INC
Provider Business Mailing Address
First Line : 4100 WOODWARD AVE
Second Line : SUITE PHARMACY
City : DETROIT
State : MI
Zip : 48201-2173
Country : US
Telephone Number : 313-832-5900
Fax Number : 313-832-5901
Provider Business Practice Location Address
First Line : 4100 WOODWARD AVE
Second Line : SUITE PHARMACY
City : DETROIT
State : MI
Zip : 48201-2173
Country : US
Telephone Number : 313-832-5900
Fax Number : 313-832-5901
Authorized Official
Title or Position : PRESIDENT
Name : MAHMOUD SROUR
Credential :
Telephone Number : 313-832-5900
Provider Enumeration Date : 09/01/2015
Last Update Date : 12/17/2015

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Directions to “MIDTOWN RX PHARMACY INC ” Practice Location

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