Provider Information for 1295987253
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
ADVANCED SPECIALTY RX LLC
Other Names:Doing Business As:ADVANCED SPECIALTY RXOrganization Subpart: NO
NPI: 1295987253
Last Updated: 2021-10-12
Certification Date: 2021-10-12
Certification Date: 2021-10-12
Details
Name | Value | ||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
NPI | 1295987253 | ||||||||||||||||||||
Enumeration Date | 2008-10-21 | ||||||||||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||||||||||
Status | Active | ||||||||||||||||||||
Authorized Official Information | Name: BASSAM YOUSSEF Title: Owner Phone: 8102308300 | ||||||||||||||||||||
Mailing Address | 4488 W BRISTOL RD STE 350 FLINT, MI 48507-3111 United States Phone: 810-232-2700 | Fax:888-246-0436 | ||||||||||||||||||||
Primary Practice Address | 4488 W BRISTOL RD STE 350 FLINT, MI 48507-3111 United States Phone: 810-232-2700 | Fax:888-246-0436 | ||||||||||||||||||||
Secondary Practice Address(es) | |||||||||||||||||||||
Health Information Exchange |
| ||||||||||||||||||||
Other Identifiers |
| ||||||||||||||||||||
Taxonomy |
|