Organization Name: | DEARBORN COMMUNITY PHARMACY LLC |
NPI Number: | 1619131141 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TOBORE UGBOSU (MANAGER) |
Mailing Address: | 8742 W Warren Ave Dearborn |
State: | MI US |
Postal Code: | 481264043 |
Phone Number: | 3139312133 |
Fax Number: | 3139313509 |
NPI Enumeration Date: | 07/14/2008 |
NPI Last Update Date: | 07/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 5301008886 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |