Healthcare Provider Details
I. General information
NPI: 1487621892
Provider Name (Legal Business Name): PHARMA CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/03/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
209 S CHERRY ST
FLUSHING MI
48433
US
IV. Provider business mailing address
PO BOX 480
FLUSHING MI
48433
US
V. Phone/Fax
- Phone: 810-659-5608
- Fax: 810-659-6789
- Phone: 810-659-5608
- Fax: 810-659-6789
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | 23D1009655 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | C |
| License Number State | MI |
VIII. Authorized Official
Name: MR.
RAYMOND
MILES
DORHOUT
SR.
Title or Position: PHARMACISTS
Credential: RPH PRESIDENT
Phone: 810-659-5608