Provider Demographics
NPI:1639576135
Name:SHOME PLLC
Entity Type:Organization
Organization Name:SHOME PLLC
Other - Org Name:AUBURN HILLS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARUP
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOME
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:248-841-1671
Mailing Address - Street 1:3089 E WALTON BLVD
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2370
Mailing Address - Country:US
Mailing Address - Phone:248-309-3333
Mailing Address - Fax:248-309-3338
Practice Address - Street 1:3089 E WALTON BLVD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2370
Practice Address - Country:US
Practice Address - Phone:248-309-3333
Practice Address - Fax:248-309-3338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010106013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy