Healthcare Provider Details

I. General information

NPI: 1750523890
Provider Name (Legal Business Name): SBC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 03/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 W. DAVISON
DETROIT MI
48238
US

IV. Provider business mailing address

PO BOX 9830
SALT LAKE CITY UT
84109
US

V. Phone/Fax

Practice location:
  • Phone: 313-935-9935
  • Fax: 313-935-9925
Mailing address:
  • Phone: 877-540-4748
  • Fax: 801-716-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number5301009082
License Number StateMI

VIII. Authorized Official

Name: JANMEYJAY VYAS
Title or Position: PRESIDENT
Credential:
Phone: 313-935-9935