Provider Demographics
NPI:1154432615
Name:AFFILIATED HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:AFFILIATED HEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PHARMACIST SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ROSEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:313-343-3945
Mailing Address - Street 1:28000 DEQUINDRE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092
Mailing Address - Country:US
Mailing Address - Phone:586-298-1733
Mailing Address - Fax:586-753-1155
Practice Address - Street 1:22151 MOROSS RD STE G25
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236-2144
Practice Address - Country:US
Practice Address - Phone:313-343-3776
Practice Address - Fax:313-417-2975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010039843336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI50-2335772Medicaid
MI50-2335772Medicaid