Healthcare Provider Details

I. General information

NPI: 1356584346
Provider Name (Legal Business Name): ONECARE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2009
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1744 W MAPLE RD STE B
BIRMINGHAM MI
48009-1545
US

IV. Provider business mailing address

PO BOX 1239
BIRMINGHAM MI
48012-1239
US

V. Phone/Fax

Practice location:
  • Phone: 248-361-6868
  • Fax: 248-817-2297
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number5301009101
License Number StateMI

VIII. Authorized Official

Name: PIERRE BOUTROS
Title or Position: PHARMACIST/OWNER
Credential: RPH
Phone: 248-361-6868