Healthcare Provider Details

I. General information

NPI: 1336383090
Provider Name (Legal Business Name): NORTH SAGINAW MI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2009
Last Update Date: 07/26/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2918 SAGINAW STREET
FLINT MI
48505
US

IV. Provider business mailing address

2918 SAGINAW STREET
FLINT MI
48505
US

V. Phone/Fax

Practice location:
  • Phone: 810-234-5500
  • Fax: 810-234-5501
Mailing address:
  • Phone: 810-234-5500
  • Fax: 810-234-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301009092
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HEMA PATEL
Title or Position: OWNER
Credential:
Phone: 810-234-5500