Provider Demographics
NPI:1164988986
Name:SAM PHARMACY LLC
Entity Type:Organization
Organization Name:SAM PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/
Authorized Official - Prefix:
Authorized Official - First Name:MAJED
Authorized Official - Middle Name:N
Authorized Official - Last Name:ALMAWRI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:313-377-9791
Mailing Address - Street 1:9550 DIX
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120-1529
Mailing Address - Country:US
Mailing Address - Phone:313-228-2414
Mailing Address - Fax:313-228-2415
Practice Address - Street 1:9550 DIX
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1529
Practice Address - Country:US
Practice Address - Phone:313-377-9791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-17
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy