Provider Demographics
NPI:1255869293
Name:ANNAOM INC
Entity Type:Organization
Organization Name:ANNAOM INC
Other - Org Name:WARREN CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:HITESHKUMAR
Authorized Official - Middle Name:RAMANLAL
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:248-979-4324
Mailing Address - Street 1:1034 DORAL DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-6130
Mailing Address - Country:US
Mailing Address - Phone:248-979-4324
Mailing Address - Fax:
Practice Address - Street 1:11460 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2631
Practice Address - Country:US
Practice Address - Phone:586-722-2842
Practice Address - Fax:586-279-1215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy