Provider Demographics
NPI:1669011524
Name:PUREPOINT PHARMACY LLC
Entity Type:Organization
Organization Name:PUREPOINT PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO, PIC
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:313-467-0264
Mailing Address - Street 1:15075 LINCOLN ST APT 110
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-1289
Mailing Address - Country:US
Mailing Address - Phone:313-467-0264
Mailing Address - Fax:
Practice Address - Street 1:15075 LINCOLN ST APT 110
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-1289
Practice Address - Country:US
Practice Address - Phone:313-467-0264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-24
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy