Provider Demographics
NPI:1497030670
Name:FADI'S PHARMACY INC
Entity Type:Organization
Organization Name:FADI'S PHARMACY INC
Other - Org Name:TOTAL COMMUNITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WISSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-277-4546
Mailing Address - Street 1:25605 JOY RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-1259
Mailing Address - Country:US
Mailing Address - Phone:313-277-4546
Mailing Address - Fax:313-277-4547
Practice Address - Street 1:8623 N TELEGRAPH RD STE 2
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-1489
Practice Address - Country:US
Practice Address - Phone:313-277-4546
Practice Address - Fax:313-277-4547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2018-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301009658333600000X, 3336C0003X
MI3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy