Provider Demographics
NPI:1770882391
Name:CITY PHARMACY, INC
Entity type:Organization
Organization Name:CITY PHARMACY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:N
Authorized Official - Last Name:DABLIZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:313-357-2700
Mailing Address - Street 1:29312 ORCHARD LAKE RD
Mailing Address - Street 2:29312 ORCHARD LAKE RD
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2967
Mailing Address - Country:US
Mailing Address - Phone:313-357-2700
Mailing Address - Fax:313-357-2702
Practice Address - Street 1:29312 ORCHARD LAKE RD
Practice Address - Street 2:29312 ORCHARD LAKE RD
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2967
Practice Address - Country:US
Practice Address - Phone:313-357-2700
Practice Address - Fax:313-357-2702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-22
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010095423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy