MEDICARE: PHARMTEK LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1457812117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMTEK LLC

Provider Business Mailing Address
First Line	:	3307 ORCHARD LAKE RD
Second Line	:
City	:	KEEGO HARBOR
State	:	MI
Zip	:	48320-1308
Country	:	US
Telephone Number	:	248-327-4244
Fax Number	:	248-859-0564

Provider Business Practice Location Address
First Line	:	3307 ORCHARD LAKE RD
Second Line	:
City	:	KEEGO HARBOR
State	:	MI
Zip	:	48320-1308
Country	:	US
Telephone Number	:	248-327-4244
Fax Number	:	248-859-0564

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. CHANEL LEE KUTEK
Credential	:
Telephone Number	:	248-327-4244

Provider Enumeration Date	:	03/26/2019
Last Update Date	:	01/28/2020

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Directions to “PHARMTEK LLC ” Practice Location

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