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NPI Code Detail

MEDICARE: SMA PATIENT CARE LLC

MEDICARE: SMA PATIENT CARE 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
13336C0003XCommunity/Retail Pharmacy5301011134MI
23336S0011XSpecialty Pharmacy
33336L0003XLong Term Care Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12168237OTHERPK

General Provider Information

NPI Number : 1851831481
Entity Type Code : Organization
Provider Name (Legal Business Name) : SMA PATIENT CARE LLC
Provider Business Mailing Address
First Line : 2708 S ROCHESTER RD STE 204
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-4577
Country : US
Telephone Number : 248-237-4455
Fax Number : 248-237-4453
Provider Business Practice Location Address
First Line : 2708 S ROCHESTER RD STE 204
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-4577
Country : US
Telephone Number : 248-237-4455
Fax Number : 248-237-4453
Authorized Official
Title or Position : RPH/OWNER
Name : SAMER NABIL YOUSSEF
Credential :
Telephone Number : 248-237-4455
Provider Enumeration Date : 03/01/2017
Last Update Date : 02/24/2020

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Directions to “SMA PATIENT CARE LLC ” Practice Location

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