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NPI Code Detail

MEDICARE: PARADISE PHARMACY, LLC

MEDICARE: PARADISE 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

General Provider Information

NPI Number : 1558039222
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARADISE PHARMACY, LLC
Provider Business Mailing Address
First Line : 13031 CONANT ST
Second Line :
City : DETROIT
State : MI
Zip : 48212-2361
Country : US
Telephone Number : 313-893-3339
Fax Number : 313-893-3337
Provider Business Practice Location Address
First Line : 13031 CONANT ST
Second Line :
City : DETROIT
State : MI
Zip : 48212-2361
Country : US
Telephone Number : 313-893-3339
Fax Number : 313-893-3337
Authorized Official
Title or Position : OWNER
Name : MR. FAHAD NAEEM
Credential :
Telephone Number : 586-554-3787
Provider Enumeration Date : 08/30/2021
Last Update Date : 09/02/2021

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Directions to “PARADISE PHARMACY, LLC ” Practice Location

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