Provider Demographics
NPI:1386972859
Name:CREAMS 'N CAPS, LLC
Entity type:Organization
Organization Name:CREAMS 'N CAPS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WISAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAWIEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-530-5769
Mailing Address - Street 1:29235 STEPHENSON HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-2300
Mailing Address - Country:US
Mailing Address - Phone:248-419-1775
Mailing Address - Fax:248-419-1788
Practice Address - Street 1:18161 W 13 MILE RD
Practice Address - Street 2:SUITE A1
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-1113
Practice Address - Country:US
Practice Address - Phone:248-419-1775
Practice Address - Fax:313-887-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-22
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0002X, 333600000X
MI53010105703336C0003X, 3336S0011X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2122903OtherPK