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NPI Code Detail

MEDICARE: VALLEY MEDICAL PHARMACY LLC

MEDICARE: VALLEY MEDICAL 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 Pharmacy5301011002MI

Other Identifiers

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

General Provider Information

NPI Number : 1952852857
Entity Type Code : Organization
Provider Name (Legal Business Name) : VALLEY MEDICAL PHARMACY LLC
Provider Business Mailing Address
First Line : 7107 N WAYNE RD STE A
Second Line :
City : WESTLAND
State : MI
Zip : 48185-2172
Country : US
Telephone Number : 313-433-2390
Fax Number : 734-729-6546
Provider Business Practice Location Address
First Line : 7107 N WAYNE RD STE A
Second Line :
City : WESTLAND
State : MI
Zip : 48185-2172
Country : US
Telephone Number : 734-729-2882
Fax Number : 734-729-6546
Authorized Official
Title or Position : MANAGER
Name : SAM A ELKHOZAI
Credential : RPH
Telephone Number : 734-729-2882
Provider Enumeration Date : 10/17/2016
Last Update Date : 12/04/2025

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Directions to “VALLEY MEDICAL PHARMACY LLC ” Practice Location

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