MEDICARE: UNION PRESCRIPTION CENTER I, INC

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	332B00000X	Durable Medical Equipment & Medical Supplies	5301004994	MI
2	3336L0003X	Long Term Care Pharmacy	5301004994	MI
3	3336C0003X	Community/Retail Pharmacy	5301004994	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2344620	OTHER		OTHER ID NUMBER

General Provider Information

NPI Number	:	1639287006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNION PRESCRIPTION CENTER I, INC

Provider Business Mailing Address
First Line	:	43155 W 9 MILE RD
Second Line	:
City	:	NOVI
State	:	MI
Zip	:	48375-4190
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11830 N SAGINAW ST
Second Line	:
City	:	MOUNT MORRIS
State	:	MI
Zip	:	48458-1504
Country	:	US
Telephone Number	:	810-686-2900
Fax Number	:	810-686-6213

Authorized Official
Title or Position	:	RPH/VP
Name	:	MR. MATTHEW S GUNN
Credential	:	RPH
Telephone Number	:	810-696-2900

Provider Enumeration Date	:	08/27/2006
Last Update Date	:	03/22/2018

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Directions to “UNION PRESCRIPTION CENTER I, INC ” Practice Location

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