National Provider Identifier Database

INDEPENDENT COMMUNITY PHARMACY INC
Clinic Pharmacy

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.


Contact Information

INDEPENDENT COMMUNITY PHARMACY INC
8742 W WARREN
DEARBORN, MI48126
Phone: 313-931-2133
Fax: 313-931-3509
Website:
Specialty Taxonomy Code
* Clinic Pharmacy 3336C0002X
Community/Retail Pharmacy 3336C0003X
Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for INDEPENDENT COMMUNITY PHARMACY INC

NPI Number 1801991757
Legal business name
LBN
INDEPENDENT COMMUNITY PHARMACY INC
Authorized official VICTOR KOBLIN - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 09/14/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers
  • MI License #: 5301003741
  • MI Medicaid: 2541233
  • Other: 2333007 OTHER ID NUMBER-COMMERCIAL NUMBER

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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