MEDICARE: PREFERRED SPECIALITY PHARMACY & HOME INFUSION

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	3336C0003X	Community/Retail Pharmacy	L1188219	MI

General Provider Information

NPI Number	:	1427250208
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED SPECIALITY PHARMACY & HOME INFUSION

Provider Business Mailing Address
First Line	:	16633 LIVERNOIS AVE
Second Line	:	STE 3
City	:	DETROIT
State	:	MI
Zip	:	48221-3098
Country	:	US
Telephone Number	:	313-864-9000
Fax Number	:	313-864-9005

Provider Business Practice Location Address
First Line	:	16633 LIVERNOIS AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48221-3098
Country	:	US
Telephone Number	:	313-864-9000
Fax Number	:	313-864-9005

Authorized Official
Title or Position	:	OWNER
Name	:	JASON DIXON
Credential	:
Telephone Number	:	313-433-2636

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	01/05/2009

Similar Medicare Providers

1902839939 — DIXON MEDICAL SUPPLIES AND SERVICES LLC
Practice Location Address:

16633 LIVERNOIS AVENUE , SUITE 1
DETROIT, MI
48221-3098

Practice Phone: 313-341-2100
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1356410328 — ONYX HOME HEALTH CARE, LLC
Practice Location Address:

16633 LIVERNOIS AVE , SUITE 2
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1982861514 — PREFERRED SPECIALTY PHARMACY AND HOME INFUSION
Practice Location Address:

16633 LIVERNOIS AVE , STE 3
DETROIT, MI
48221-3098

Practice Phone: 313-864-9000
Practice Fax: 313-864-9005

1427549096 — HUSSIEN SAM BAYDOUN DDS
Practice Location Address:

24366 GRAND RIVER AVE
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48219-3098

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Practice Fax:

1104471887 — JOSEPH AZZOUZ DDS
Practice Location Address:

24366 GRAND RIVER AVE
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1245182682 — HADASSAH SANDRA MCKNIGHT ED.D
Practice Location Address:

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Practice Fax:

Directions to “PREFERRED SPECIALITY PHARMACY & HOME INFUSION ” Practice Location

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