Indian Village Pharmacy

LBN: Indian Village Pharmacy
Indian Village Pharmacy is an health care organization with primary practice located at 8415 E Jefferson Ave , Detroit MI 48214-2721. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Indian Village Pharmacy can be contacted via phone (313) 331-2000, or through Aoun, Imad via phone (313) 331-2000.

Contact Information

Primary practice address
8415 E Jefferson Ave Detroit MI 48214-2721
Phone: (313) 331-2000
Fax: (313) 331-2001
Website:
Map and Directions
Authorized official contact:
Name: Aoun, Imad BS
Phone: (313) 331-2000

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 5301007723 Michigan

Profile Details

NPI number 1306904032
LBN Legal business name Indian Village Pharmacy
DBA Doing business as Indian Village Pharmacy
Authorized official Aoun, Imad BS
Entity Organization
Organization subpart 1 No
Enumeration date Dec 5th, 2006
Last updated Jul 19th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306904032 NPPES
Michigan MEDICAID 4548959
Michigan Other 2046489

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