Provider Demographics
NPI:1427164409
Name:BIRMIMGHAMDRUGSINC
Entity type:Organization
Organization Name:BIRMIMGHAMDRUGSINC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:Z
Authorized Official - Last Name:KRASNICK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:248-644-3214
Mailing Address - Street 1:33877 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-0915
Mailing Address - Country:US
Mailing Address - Phone:248-644-3214
Mailing Address - Fax:248-644-6961
Practice Address - Street 1:33877 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-0915
Practice Address - Country:US
Practice Address - Phone:248-644-3214
Practice Address - Fax:248-644-6961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301000095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty