Provider Demographics
NPI:1679373096
Name:DOCTORS MEDICAL PHARMACY LLC
Entity type:Organization
Organization Name:DOCTORS MEDICAL PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMMI
Authorized Official - Middle Name:
Authorized Official - Last Name:OMAR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:313-832-2050
Mailing Address - Street 1:3169 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2723
Mailing Address - Country:US
Mailing Address - Phone:313-832-4810
Mailing Address - Fax:313-832-4812
Practice Address - Street 1:3169 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2723
Practice Address - Country:US
Practice Address - Phone:313-832-4810
Practice Address - Fax:313-832-4812
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOCTOR'S MEDICAL PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-14
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy