Provider Demographics
NPI:1669012316
Name:WARRIORS PHARMACY, INC.
Entity Type:Organization
Organization Name:WARRIORS PHARMACY, INC.
Other - Org Name:WARRIORS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:KASSEM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEHAB
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:313-774-0520
Mailing Address - Street 1:5265 ANTHONY WAYNE DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3947
Mailing Address - Country:US
Mailing Address - Phone:313-774-0520
Mailing Address - Fax:
Practice Address - Street 1:5265 ANTHONY WAYNE DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3947
Practice Address - Country:US
Practice Address - Phone:313-622-3189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy