Provider Demographics
NPI:1316400906
Name:3 BROTHERS PHARMACY LLC
Entity Type:Organization
Organization Name:3 BROTHERS PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ODEH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:586-298-6282
Mailing Address - Street 1:25656 SCHOENHERR RD STE B
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-1492
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25656 SCHOENHERR RD STE B
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-1492
Practice Address - Country:US
Practice Address - Phone:586-298-6282
Practice Address - Fax:586-298-6935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-10
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy