Provider Demographics
NPI:1700461100
Name:BINGHAM PHARMACY, PLLC
Entity Type:Organization
Organization Name:BINGHAM PHARMACY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:H
Authorized Official - Last Name:AYAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-496-1430
Mailing Address - Street 1:13320 W WARREN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-1417
Mailing Address - Country:US
Mailing Address - Phone:313-581-4451
Mailing Address - Fax:313-581-7560
Practice Address - Street 1:13320 W WARREN AVE STE B
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-1417
Practice Address - Country:US
Practice Address - Phone:313-581-4451
Practice Address - Fax:313-581-7560
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOHAMED AYAD, M.D., P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-17
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy