Provider Demographics
NPI:1285645580
Name:TRUE CARE PHARMACY INC
Entity Type:Organization
Organization Name:TRUE CARE PHARMACY INC
Other - Org Name:TRUE CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:M
Authorized Official - Last Name:SOBH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-292-2716
Mailing Address - Street 1:21225 ECORSE RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-1834
Mailing Address - Country:US
Mailing Address - Phone:313-292-2716
Mailing Address - Fax:313-292-2724
Practice Address - Street 1:21225 ECORSE RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-1834
Practice Address - Country:US
Practice Address - Phone:313-292-2716
Practice Address - Fax:313-292-2724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010077423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI540H216140OtherBLUE CROSS BLUE SHEILD
MI1609169Medicaid
MI1609169Medicaid