Provider Demographics
NPI:1114423365
Name:APOTHECO PHARMACY TROY LLC
Entity type:Organization
Organization Name:APOTHECO PHARMACY TROY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-869-2820
Mailing Address - Street 1:2924 W MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-7031
Mailing Address - Country:US
Mailing Address - Phone:248-850-1376
Mailing Address - Fax:248-850-1559
Practice Address - Street 1:2924 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-7031
Practice Address - Country:US
Practice Address - Phone:248-850-1376
Practice Address - Fax:248-850-1559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-04
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2177468OtherPK