Provider Demographics
NPI:1053402867
Name:SUTTONS DRUG INC
Entity type:Organization
Organization Name:SUTTONS DRUG INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THAMER
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALKHATEEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-722-0162
Mailing Address - Street 1:12101 JOSEPH CAMPAU ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-2590
Mailing Address - Country:US
Mailing Address - Phone:313-305-4746
Mailing Address - Fax:313-305-4759
Practice Address - Street 1:12101 JOSEPH CAMPAU ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-2590
Practice Address - Country:US
Practice Address - Phone:313-305-4746
Practice Address - Fax:313-305-4759
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DESH RX PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-27
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010073633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy