Provider Demographics
NPI:1548559578
Name:A & A PHARMACY LLC
Entity Type:Organization
Organization Name:A & A PHARMACY LLC
Other - Org Name:A & A PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RABIH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-584-0600
Mailing Address - Street 1:15343 W WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1357
Mailing Address - Country:US
Mailing Address - Phone:313-584-0600
Mailing Address - Fax:313-584-6462
Practice Address - Street 1:15343 W WARREN AVE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1357
Practice Address - Country:US
Practice Address - Phone:313-584-0600
Practice Address - Fax:313-584-6462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010095473336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2375459OtherNCPDP PROVIDER IDENTIFICATION NUMBER