Provider Demographics
NPI:1508966995
Name:A & C PHARMACY INC
Entity Type:Organization
Organization Name:A & C PHARMACY INC
Other - Org Name:GOOD NEIGHBOR'S FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:ELKHATIB
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:734-722-8774
Mailing Address - Street 1:1956 VENOY RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186
Mailing Address - Country:US
Mailing Address - Phone:734-722-8774
Mailing Address - Fax:734-722-8214
Practice Address - Street 1:1956 VENOY RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186
Practice Address - Country:US
Practice Address - Phone:734-722-8774
Practice Address - Fax:734-722-8214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010071873336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2361323OtherNCPDP
MI540H21778OtherBCBSM
MI874240640Medicaid
MI3903730001Medicare NSC