Healthcare Provider Details

I. General information

NPI: 1457469819
Provider Name (Legal Business Name): CARLETON DRUGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 06/28/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MEDICAL CENTER DR
CARLETON MI
48117
US

IV. Provider business mailing address

201 MEDICAL CENTER DR
CARLETON MI
48117
US

V. Phone/Fax

Practice location:
  • Phone: 734-654-6252
  • Fax: 734-654-0268
Mailing address:
  • Phone: 734-654-6252
  • Fax: 734-654-0268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301010797
License Number StateMI

VIII. Authorized Official

Name: MR. WILLIAM NEWMAN
Title or Position: OWNER
Credential: CPA
Phone: 734-654-6252