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NPI Code Detail

MEDICARE: TRUHEALTH PHARMACY LLC

MEDICARE: TRUHEALTH PHARMACY LLC
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
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy5301010989MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22162538OTHERPK

General Provider Information

NPI Number : 1487108866
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRUHEALTH PHARMACY LLC
Provider Business Mailing Address
First Line : 25302 W WARREN ST
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-2102
Country : US
Telephone Number : 313-769-5551
Fax Number : 313-556-2474
Provider Business Practice Location Address
First Line : 25302 W WARREN ST
Second Line :
City : DEARBORN HEIGHTS
State : MI
Zip : 48127-2102
Country : US
Telephone Number : 313-769-5551
Fax Number : 313-556-2474
Authorized Official
Title or Position : PIC
Name : RAMZI KASSEM
Credential :
Telephone Number : 313-769-5551
Provider Enumeration Date : 08/15/2016
Last Update Date : 09/26/2016

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Directions to “TRUHEALTH PHARMACY LLC ” Practice Location

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