Provider Demographics
NPI:1780904748
Name:VIP PHARMACY INC
Entity type:Organization
Organization Name:VIP PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMIEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-205-2000
Mailing Address - Street 1:14319 DIX TOLEDO RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-2506
Mailing Address - Country:US
Mailing Address - Phone:734-281-8899
Mailing Address - Fax:734-281-8911
Practice Address - Street 1:14319 DIX TOLEDO RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2506
Practice Address - Country:US
Practice Address - Phone:734-281-8899
Practice Address - Fax:734-281-8911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010093643336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy