Provider Demographics
NPI:1760750558
Name:DIX FAMILY CARE PHARMACY LLC
Entity Type:Organization
Organization Name:DIX FAMILY CARE PHARMACY LLC
Other - Org Name:DIX FAMILY CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NABIL
Authorized Official - Middle Name:MOHSEN MOHSEN
Authorized Official - Last Name:AL-SUBARI
Authorized Official - Suffix:SR
Authorized Official - Credentials:RPH
Authorized Official - Phone:313-914-5556
Mailing Address - Street 1:10035 VERNOR HWY
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120-1513
Mailing Address - Country:US
Mailing Address - Phone:313-914-5556
Mailing Address - Fax:313-914-5510
Practice Address - Street 1:10035 VERNOR HWY
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1513
Practice Address - Country:US
Practice Address - Phone:313-914-5556
Practice Address - Fax:313-914-5510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty