Provider Demographics
NPI:1124168513
Name:SAV MART PHARMACY
Entity type:Organization
Organization Name:SAV MART PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WALEED
Authorized Official - Middle Name:M
Authorized Official - Last Name:YAGHMOUR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:313-923-0007
Mailing Address - Street 1:7011 GRATIOT AVE
Mailing Address - Street 2:SAV-MART PHARMACY
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-1973
Mailing Address - Country:US
Mailing Address - Phone:313-923-0007
Mailing Address - Fax:
Practice Address - Street 1:7011 GRATIOT AVE
Practice Address - Street 2:SAV-MART PHARMACY
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-1973
Practice Address - Country:US
Practice Address - Phone:313-923-0007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010079931835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Multi-Specialty