Provider Demographics
NPI:1336616671
Name:GROESBECK RX LLC
Entity Type:Organization
Organization Name:GROESBECK RX LLC
Other - Org Name:GROESBECK RX LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:SAAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-333-5845
Mailing Address - Street 1:28035 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LATHRUP VILLAGE
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2858
Mailing Address - Country:US
Mailing Address - Phone:586-333-5845
Mailing Address - Fax:586-333-5887
Practice Address - Street 1:28035 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LATHRUP VILLAGE
Practice Address - State:MI
Practice Address - Zip Code:48076-2858
Practice Address - Country:US
Practice Address - Phone:586-333-5845
Practice Address - Fax:586-333-5887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-25
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy