Provider Demographics
NPI:1053119610
Name:CARE COMPOUND PHARMACY MI LLC
Entity type:Organization
Organization Name:CARE COMPOUND PHARMACY MI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUNDIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHWEHDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-658-9129
Mailing Address - Street 1:5111 AUTO CLUB DR STE 101A
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2749
Mailing Address - Country:US
Mailing Address - Phone:313-879-0346
Mailing Address - Fax:313-528-2266
Practice Address - Street 1:5111 AUTO CLUB DR STE 101A
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2749
Practice Address - Country:US
Practice Address - Phone:313-879-0346
Practice Address - Fax:313-528-2266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy