Provider Demographics
NPI:1033479613
Name:PHARMASCRIPT OF SHELBY INC
Entity Type:Organization
Organization Name:PHARMASCRIPT OF SHELBY INC
Other - Org Name:PHARMASCRIPT OF SHELBY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-598-3833
Mailing Address - Street 1:50505 SCHOENHERR RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-3140
Mailing Address - Country:US
Mailing Address - Phone:586-803-0800
Mailing Address - Fax:586-803-0801
Practice Address - Street 1:50505 SCHOENHERR RD
Practice Address - Street 2:SUITE 130
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48315-3140
Practice Address - Country:US
Practice Address - Phone:586-803-0800
Practice Address - Fax:586-803-0801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010098203336C0003X
MI3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2376792OtherNCPDP PROVIDER IDENTIFICATION NUMBER