Provider Demographics
NPI:1851831481
Name:SMA PATIENT CARE LLC
Entity Type:Organization
Organization Name:SMA PATIENT CARE LLC
Other - Org Name:SOMERSET SPECIALTY PHARMACY ROCHESTER HILLS , LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPH/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:NABIL
Authorized Official - Last Name:YOUSSEF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-237-4455
Mailing Address - Street 1:2708 S ROCHESTER RD STE 204
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-4577
Mailing Address - Country:US
Mailing Address - Phone:248-237-4455
Mailing Address - Fax:248-237-4453
Practice Address - Street 1:2708 S ROCHESTER RD STE 204
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4577
Practice Address - Country:US
Practice Address - Phone:248-237-4455
Practice Address - Fax:248-237-4453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010111343336C0003X
3336L0003X, 3336S0011X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2168237OtherPK