Provider Demographics
NPI:1689064735
Name:PHARM E-Z, INC.
Entity Type:Organization
Organization Name:PHARM E-Z, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMMOH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:586-698-1874
Mailing Address - Street 1:35814 DEQUINDRE RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4290
Mailing Address - Country:US
Mailing Address - Phone:586-698-1874
Mailing Address - Fax:586-264-2437
Practice Address - Street 1:35814 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4290
Practice Address - Country:US
Practice Address - Phone:586-698-1874
Practice Address - Fax:586-264-2437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-28
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7341450001Medicare NSC