Provider Demographics
NPI:1710077912
Name:RX MART INC
Entity Type:Organization
Organization Name:RX MART INC
Other - Org Name:REID'S DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:M
Authorized Official - Last Name:NASSER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:313-921-3536
Mailing Address - Street 1:9938 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48213-3110
Mailing Address - Country:US
Mailing Address - Phone:313-921-3536
Mailing Address - Fax:313-921-8020
Practice Address - Street 1:9938 HARPER AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48213-3110
Practice Address - Country:US
Practice Address - Phone:313-921-3536
Practice Address - Fax:313-921-8020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301007091302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5336710001Medicare NSC