Healthcare Provider Details

I. General information

NPI: 1912015371
Provider Name (Legal Business Name): SEWARD DRUG CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 04/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25190 VAN BORN RD
DEARBORN HTS MI
48125-2009
US

IV. Provider business mailing address

43155 W 9 MILE RD
NOVI MI
48375-4190
US

V. Phone/Fax

Practice location:
  • Phone: 313-292-2520
  • Fax: 313-292-2675
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301002365
License Number StateMI

VIII. Authorized Official

Name: STEPHEN GRAHAM
Title or Position: MANAGER PHARMACY SERVICES
Credential:
Phone: 248-348-1570