Provider Demographics
NPI:1790965127
Name:HARI OHM PHARMACY INC
Entity Type:Organization
Organization Name:HARI OHM PHARMACY INC
Other - Org Name:KRAUZERS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:HUMAIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-366-4600
Mailing Address - Street 1:19953 CONANT ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-1334
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19953 CONANT ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-1334
Practice Address - Country:US
Practice Address - Phone:313-366-4600
Practice Address - Fax:313-366-4601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010087413336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2370473OtherOTHER ID NUMBER