Healthcare Provider Details
I. General information
NPI: 1912917261
Provider Name (Legal Business Name): APEX DRUG STORES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/09/2006
Last Update Date: 03/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1900 EAST EIGHT MILE ROAD
DETROIT MI
48234-1008
US
IV. Provider business mailing address
200 NEWBERRY COMMONS
ETTERS PA
17319-9363
US
V. Phone/Fax
- Phone: 313-892-4600
- Fax:
- Phone: 717-761-2633
- Fax: 717-975-8659
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 5301004148 |
| License Number State | MI |
VIII. Authorized Official
Name:
JENNIFER
ZOREK
Title or Position: MANAGER ONLINE ADJUDICATION
Credential:
Phone: 717-975-5937