Provider Demographics
NPI:1689949430
Name:PALM DRUGS INC
Entity Type:Organization
Organization Name:PALM DRUGS INC
Other - Org Name:PALM DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSAMARAE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-673-1151
Mailing Address - Street 1:6650 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1701
Mailing Address - Country:US
Mailing Address - Phone:313-436-0156
Mailing Address - Fax:313-436-0153
Practice Address - Street 1:6650 GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1701
Practice Address - Country:US
Practice Address - Phone:313-436-0156
Practice Address - Fax:313-436-0153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MI53010098043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
2133377OtherPK