Healthcare Provider Details
I. General information
NPI: 1316639958
Provider Name (Legal Business Name): ALMONT PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2023
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4545 VAN DYKE RD
ALMONT MI
48003-8511
US
IV. Provider business mailing address
4545 VAN DYKE RD
ALMONT MI
48003-8511
US
V. Phone/Fax
- Phone: 810-634-3164
- Fax: 810-673-3141
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHACKO
JOSEPH
PUTHENTHARAYIL
Title or Position: OWNER/PRESIDENT
Credential: PHARMACIST
Phone: 248-946-7725