Provider Demographics
NPI:1558476176
Name:INTERNATIONAL PHARMACY CARE, INC.
Entity Type:Organization
Organization Name:INTERNATIONAL PHARMACY CARE, INC.
Other - Org Name:PHARMASCRIPT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHEHADI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:248-435-3500
Mailing Address - Street 1:1380 COOLIDGE HWY
Mailing Address - Street 2:SUITE L50
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-7069
Mailing Address - Country:US
Mailing Address - Phone:248-435-3500
Mailing Address - Fax:248-435-8643
Practice Address - Street 1:1380 COOLIDGE HWY
Practice Address - Street 2:STE. L50
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-7018
Practice Address - Country:US
Practice Address - Phone:248-435-8643
Practice Address - Fax:248-435-8643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010077563336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5197260001Medicare ID - Type UnspecifiedPHARMACY