Provider Demographics
NPI:1578961306
Name:NEW SCHAEFER PHARMACY INC
Entity Type:Organization
Organization Name:NEW SCHAEFER PHARMACY INC
Other - Org Name:NEW SCHAEFER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HUSSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSTAPHA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:313-582-1800
Mailing Address - Street 1:6635 SCHAEFER RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1812
Mailing Address - Country:US
Mailing Address - Phone:313-582-1800
Mailing Address - Fax:313-582-2894
Practice Address - Street 1:6635 SCHAEFER RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1812
Practice Address - Country:US
Practice Address - Phone:313-582-1800
Practice Address - Fax:313-582-2894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-10
Last Update Date:2016-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010068673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy