Provider Demographics
NPI:1225376486
Name:PIONEER DRUGS INC
Entity Type:Organization
Organization Name:PIONEER DRUGS INC
Other - Org Name:WESTBORN PHARMACY 8
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-438-6476
Mailing Address - Street 1:1800 GRINDLEY PARK ST
Mailing Address - Street 2:STE 1
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2553
Mailing Address - Country:US
Mailing Address - Phone:313-438-6476
Mailing Address - Fax:313-438-6478
Practice Address - Street 1:1800 GRINDLEY PARK ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2553
Practice Address - Country:US
Practice Address - Phone:313-438-6476
Practice Address - Fax:313-438-6478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MI53010110163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2138660OtherPK
MI2377580Medicaid