Provider Demographics
NPI:1083019079
Name:NEAU ERA PHARMACY
Entity type:Organization
Organization Name:NEAU ERA PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:LAWRETTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:AMADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-722-1476
Mailing Address - Street 1:506 N TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-1038
Mailing Address - Country:US
Mailing Address - Phone:248-975-9300
Mailing Address - Fax:248-975-9301
Practice Address - Street 1:506 N TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341
Practice Address - Country:US
Practice Address - Phone:248-975-9300
Practice Address - Fax:248-975-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-03
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010105953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy