Provider Demographics
NPI:1265830400
Name:GREENFIELD HEALTH PHARMACY INC
Entity Type:Organization
Organization Name:GREENFIELD HEALTH PHARMACY INC
Other - Org Name:GREENFIELD HEALTH PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FADI
Authorized Official - Middle Name:
Authorized Official - Last Name:SAAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-585-7657
Mailing Address - Street 1:15343 W WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1357
Mailing Address - Country:US
Mailing Address - Phone:313-846-9090
Mailing Address - Fax:313-846-9092
Practice Address - Street 1:15343 W WARREN AVE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1357
Practice Address - Country:US
Practice Address - Phone:313-846-9090
Practice Address - Fax:313-846-9092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-19
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010106153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2149360OtherPK