Provider Demographics
NPI:1790150266
Name:ZMC PHARMACY
Entity Type:Organization
Organization Name:ZMC PHARMACY
Other - Org Name:ZMC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:JALAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAWAIDEH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:248-280-6409
Mailing Address - Street 1:1041 S MAIN ST
Mailing Address - Street 2:FL1
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-3274
Mailing Address - Country:US
Mailing Address - Phone:248-280-6401
Mailing Address - Fax:248-280-6411
Practice Address - Street 1:1041 S MAIN ST
Practice Address - Street 2:FL1
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-3274
Practice Address - Country:US
Practice Address - Phone:248-280-6401
Practice Address - Fax:248-280-6411
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ZMC PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010088893336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy