MEDICARE: VILLAGE PHARMACY WEST BLOOMFIELD, 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	183500000X	Pharmacist

General Provider Information

NPI Number	:	1568320745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE PHARMACY WEST BLOOMFIELD, INC.

Provider Business Mailing Address
First Line	:	6565 ORCHARD LAKE RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-3403
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6565 ORCHARD LAKE RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-3403
Country	:	US
Telephone Number	:	248-487-7019
Fax Number	:	248-487-9409

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	MR. ADAM NABIL ZAWAIDEH
Credential	:
Telephone Number	:	248-224-0525

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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