Healthcare Provider Details

I. General information

NPI: 1003296542
Provider Name (Legal Business Name): DKB DRUGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2015
Last Update Date: 05/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42621 GARFIELD RD SUITE 101A
CLINTON TOWNSHIP MI
48038-5031
US

IV. Provider business mailing address

42621 GARFIELD RD SUITE 101A
CLINTON TOWNSHIP MI
48038-5031
US

V. Phone/Fax

Practice location:
  • Phone: 586-213-1386
  • Fax: 586-213-1397
Mailing address:
  • Phone: 586-213-1386
  • Fax: 586-213-1397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301011166
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number5301011166
License Number StateMI

VIII. Authorized Official

Name: MR. DAXESH V PATEL
Title or Position: PHARMACIST IN CHARGE, PRESIDENT
Credential: RPH
Phone: 586-213-1386