Provider Demographics
NPI:1639766645
Name:UNIFIED PHARMACY, LLC
Entity Type:Organization
Organization Name:UNIFIED PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEINOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-434-2448
Mailing Address - Street 1:2287 ELLSWORTH RD STE A
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-4805
Mailing Address - Country:US
Mailing Address - Phone:734-434-2448
Mailing Address - Fax:734-434-2458
Practice Address - Street 1:3950 MOUNT ELLIOTT ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-1841
Practice Address - Country:US
Practice Address - Phone:313-579-5502
Practice Address - Fax:313-579-5504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1033151568Medicaid