Provider Demographics
NPI:1215978648
Name:ADRIAN DISCOUNT DRUGS INC
Entity type:Organization
Organization Name:ADRIAN DISCOUNT DRUGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:517-263-4440
Mailing Address - Street 1:700 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-3079
Mailing Address - Country:US
Mailing Address - Phone:517-263-4440
Mailing Address - Fax:
Practice Address - Street 1:700 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-3079
Practice Address - Country:US
Practice Address - Phone:517-263-4440
Practice Address - Fax:517-438-8215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5306004579332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
2300159OtherOTHER ID NUMBER-COMMERCIAL NUMBER
2300159OtherOTHER ID NUMBER
MI2531578Medicaid
MI2531578Medicaid
0P49200Medicare PIN