Provider Demographics
NPI:1932502283
Name:ARK PHARMACY LLC
Entity Type:Organization
Organization Name:ARK PHARMACY LLC
Other - Org Name:ARK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FATME
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHCHE
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:313-469-8112
Mailing Address - Street 1:11250 E JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-3301
Mailing Address - Country:US
Mailing Address - Phone:313-469-8112
Mailing Address - Fax:313-499-1329
Practice Address - Street 1:11250 E JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-3301
Practice Address - Country:US
Practice Address - Phone:313-469-8112
Practice Address - Fax:313-499-1329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301010573333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy