Provider Demographics
NPI:1699780205
Name:HEALTH MAINTENANCE PHARMACIES INC.
Entity type:Organization
Organization Name:HEALTH MAINTENANCE PHARMACIES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHCIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DALEHLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-354-5600
Mailing Address - Street 1:29877 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1332
Mailing Address - Country:US
Mailing Address - Phone:248-354-5600
Mailing Address - Fax:248-354-0148
Practice Address - Street 1:29877 TELEGRAPH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1332
Practice Address - Country:US
Practice Address - Phone:248-354-5600
Practice Address - Fax:248-354-0148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0002X, 3336M0002X
MI53010035833336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2042925OtherPK