Provider Demographics
NPI:1326053935
Name:METROPOLITAN PHARMACY
Entity Type:Organization
Organization Name:METROPOLITAN PHARMACY
Other - Org Name:METROPOLITAN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OUSSAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-937-1100
Mailing Address - Street 1:26380 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-2211
Mailing Address - Country:US
Mailing Address - Phone:313-937-1100
Mailing Address - Fax:313-937-0554
Practice Address - Street 1:26380 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-2211
Practice Address - Country:US
Practice Address - Phone:313-937-1100
Practice Address - Fax:313-937-0594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MI53010082773336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2042095OtherPK