Provider Demographics
NPI:1003299918
Name:MAUMEE DISCOUNT PHARMACY
Entity Type:Organization
Organization Name:MAUMEE DISCOUNT PHARMACY
Other - Org Name:MAUMEE DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER,AO
Authorized Official - Prefix:
Authorized Official - First Name:BILAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SALIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-345-7253
Mailing Address - Street 1:316 W DUSSEL DR
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1671
Mailing Address - Country:US
Mailing Address - Phone:419-887-0101
Mailing Address - Fax:419-865-3300
Practice Address - Street 1:316 W DUSSEL DR
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1671
Practice Address - Country:US
Practice Address - Phone:419-887-0101
Practice Address - Fax:419-887-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-09
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRTP022538150033336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2153522OtherPK