Provider Demographics
NPI:1033959820
Name:ESSENTIAL PHARMACY, LLC
Entity type:Organization
Organization Name:ESSENTIAL PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:DAOUD
Authorized Official - Last Name:BAZZI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:313-804-8445
Mailing Address - Street 1:17600 W WARREN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-3509
Mailing Address - Country:US
Mailing Address - Phone:313-633-1998
Mailing Address - Fax:313-633-1798
Practice Address - Street 1:17600 W WARREN AVE STE A
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-3509
Practice Address - Country:US
Practice Address - Phone:313-633-1998
Practice Address - Fax:313-633-1798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy