Provider Demographics
NPI: | 1407861347 |
---|---|
Name: | CARING PHAMRACY |
Entity type: | Organization |
Organization Name: | CARING PHAMRACY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JYOTSANA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PATEL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 313-935-9935 |
Mailing Address - Street 1: | 4000 W DAVISON |
Mailing Address - Street 2: | |
Mailing Address - City: | DETROIT |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48238-3263 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 313-935-9935 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4000 W DAVISON |
Practice Address - Street 2: | |
Practice Address - City: | DETROIT |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48238-3263 |
Practice Address - Country: | US |
Practice Address - Phone: | 313-935-9935 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-07-29 |
Last Update Date: | 2008-02-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MI | 5315025647 | 3336C0003X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 3336C0003X | Suppliers | Pharmacy | Community/Retail Pharmacy |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MI | 5678770001 | Medicare NSC |