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NPI Code Detail

MEDICARE: MEDPLUS CARE PHARMACY LLC

MEDICARE: MEDPLUS CARE PHARMACY 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
1333600000XPharmacy
23336C0004XCompounding Pharmacy
33336S0011XSpecialty Pharmacy
43336C0003XCommunity/Retail Pharmacy5301010013MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12377617OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1508105883
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDPLUS CARE PHARMACY LLC
Provider Business Mailing Address
First Line : 14071 E 7 MILE RD
Second Line :
City : DETROIT
State : MI
Zip : 48205-2335
Country : US
Telephone Number : 313-371-9000
Fax Number : 313-371-9005
Provider Business Practice Location Address
First Line : 14071 E 7 MILE RD
Second Line :
City : DETROIT
State : MI
Zip : 48205-2335
Country : US
Telephone Number : 313-371-9000
Fax Number : 313-371-9005
Authorized Official
Title or Position : PRESIDENT
Name : ANURADHA CHITTIPROLU
Credential :
Telephone Number : 313-371-9000
Provider Enumeration Date : 02/07/2013
Last Update Date : 03/14/2016

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Directions to “MEDPLUS CARE PHARMACY LLC ” Practice Location

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