Provider Demographics
NPI:1538466545
Name:MONROE FAMILY PHARMACY INC
Entity Type:Organization
Organization Name:MONROE FAMILY PHARMACY INC
Other - Org Name:MONROE FAMILY PHARMACY, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:AIMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUEIDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-441-6666
Mailing Address - Street 1:6907 BARRIE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1773
Mailing Address - Country:US
Mailing Address - Phone:313-523-5334
Mailing Address - Fax:313-441-3700
Practice Address - Street 1:14750 LAPLAISANCE RD
Practice Address - Street 2:STE 270
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-3899
Practice Address - Country:US
Practice Address - Phone:313-441-6666
Practice Address - Fax:313-441-3700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-28
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2375170OtherNCPDP PROVIDER IDENTIFICATION NUMBER