Provider Demographics
NPI:1063254266
Name:ABES DRUG STORE 103 LLC
Entity type:Organization
Organization Name:ABES DRUG STORE 103 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALOUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-728-5048
Mailing Address - Street 1:1159 E MICHIGAN AVE STE C
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5807
Mailing Address - Country:US
Mailing Address - Phone:734-485-9900
Mailing Address - Fax:734-485-9300
Practice Address - Street 1:1159 E MICHIGAN AVE STE C
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5807
Practice Address - Country:US
Practice Address - Phone:734-485-9900
Practice Address - Fax:734-485-9300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy