Provider Demographics
NPI:1013260249
Name:R PHARMACY INC
Entity type:Organization
Organization Name:R PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / PHARMACIST IN CHARGE
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAZZI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:734-367-3000
Mailing Address - Street 1:5727 INKSTER RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2960
Mailing Address - Country:US
Mailing Address - Phone:734-367-3000
Mailing Address - Fax:734-367-3011
Practice Address - Street 1:5727 INKSTER RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2960
Practice Address - Country:US
Practice Address - Phone:734-367-3000
Practice Address - Fax:734-367-3011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI11111111183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PENDINGOtherPENDING