Organization Name: | VENOY MEDICAL PHARMACY |
NPI Number: | 1760527659 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHAWKI M FAKIH (PHARMASIST) |
Mailing Address: | 4020 Venoy Rd Ste 200a Wayne |
State: | MI US |
Postal Code: | 481841869 |
Phone Number: | 7347292882 |
Fax Number: | 7347294586 |
NPI Enumeration Date: | 02/20/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251K00000X |
License Number: | 5301006869 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Public Health or Welfare |
Taxonomy Specialization: | |
Taxonomy Definition: |