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| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | Buckley's Pharmacy 102 | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States | [sources] | |||
| Description | License number: 5301009840 | [sources] | |||
| NPI | 1962764506 | [sources] | |||
| Registration number | not available | [sources] | |||
| Sector | Pharmacy | [sources] | |||
| Address | Hazel Park, MI | [sources] | |||
| Last change | Last processed | First seen | |||
Providers who have been terminated for cause from Michigan's Medicaid program.
United States · MDHHS
us-medmi-7585d4612abf3d4c70e2fb4f1e640fd84fc64102 · us-npi-1962764506For experts: raw data explorer
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States | Michigan Department of Health & Human Services | - | |||
| Linked from | ||||
|---|---|---|---|---|
| Subject | Role | Start date | End date | |
| Samir Anthony Shamimur Berri Cole Rahman Debarred entity | - | - | - | |