Provider Demographics
NPI:1255874384
Name:HADY ENTERPRISES INC
Entity type:Organization
Organization Name:HADY ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD KAML
Authorized Official - Middle Name:
Authorized Official - Last Name:ALOUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-728-5048
Mailing Address - Street 1:1513 S CENTER RD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48509-1728
Mailing Address - Country:US
Mailing Address - Phone:810-309-3209
Mailing Address - Fax:
Practice Address - Street 1:1513 S CENTER RD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1728
Practice Address - Country:US
Practice Address - Phone:810-309-3209
Practice Address - Fax:810-221-7356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MI53010110583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1255874384Medicaid
2166462OtherPK