Provider Demographics
NPI:1134693559
Name:RICHTER'S DRUGS ,LLC
Entity Type:Organization
Organization Name:RICHTER'S DRUGS ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDALLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KHASHAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-802-0248
Mailing Address - Street 1:1621 N MILDRED ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48128-1215
Mailing Address - Country:US
Mailing Address - Phone:248-802-0248
Mailing Address - Fax:
Practice Address - Street 1:23920 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1833
Practice Address - Country:US
Practice Address - Phone:248-802-0248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy