Provider Demographics
NPI:1891147955
Name:DR PHARMACY LLC
Entity Type:Organization
Organization Name:DR PHARMACY LLC
Other - Org Name:DOCTOR'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CERTIFIED PHARMACY TECHNICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:ROUD
Authorized Official - Middle Name:
Authorized Official - Last Name:HAJJAHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-777-2190
Mailing Address - Street 1:18801 E 10 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-3931
Mailing Address - Country:US
Mailing Address - Phone:586-777-2190
Mailing Address - Fax:586-777-5847
Practice Address - Street 1:18801 E 10 MILE RD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-3931
Practice Address - Country:US
Practice Address - Phone:586-777-2190
Practice Address - Fax:586-777-5847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010108953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy