Medsource Pharmacy
LBN: Medsource Family Pharmacy Llc
Medsource Pharmacy is an health care organization with primary practice located at 15300 W 9 Mile Rd Ste 2 , Oak Park MI 48237-5200. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Medsource Family Pharmacy Llc can be contacted via phone (248) 850-8594, or through Dagher, Hadi via phone (313) 717-2900.
Contact Information
Primary practice address
15300 W 9 Mile Rd Ste 2
Oak Park MI 48237-5200
Phone: (248) 850-8594
Fax: (248) 629-9839
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 5301011057 | Michigan |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1174079560 |
|---|---|
| LBN Legal business name | Medsource Family Pharmacy Llc |
| DBA Doing business as | Medsource Pharmacy |
| Authorized official | Dagher, Hadi RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 26th, 2016 |
| Last updated | Jan 18th, 2017 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174079560 | NPPES |
| Other | 2163895 | PK |
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