Provider Demographics
NPI:1306618509
Name:HIGHLAND PHARMACY LLC
Entity type:Organization
Organization Name:HIGHLAND PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:248-977-1394
Mailing Address - Street 1:4000 HIGHLAND RD STE 113
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-2163
Mailing Address - Country:US
Mailing Address - Phone:248-977-1394
Mailing Address - Fax:248-977-1395
Practice Address - Street 1:4000 HIGHLAND RD STE 113
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-2163
Practice Address - Country:US
Practice Address - Phone:248-977-1394
Practice Address - Fax:248-977-1395
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGHLAND PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-23
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy