Healthcare Provider Details

I. General information

NPI: 1467729046
Provider Name (Legal Business Name): RITE WAY PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2011
Last Update Date: 11/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 OAKWOOD BLVD
MELVINDALE MI
48122-1150
US

IV. Provider business mailing address

3600 OAKWOOD BLVD
MELVINDALE MI
48122-1150
US

V. Phone/Fax

Practice location:
  • Phone: 313-451-8566
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5315052965
License Number StateMI

VIII. Authorized Official

Name: MR. IME EQUERE
Title or Position: CO-OWNER
Credential:
Phone: 313-451-8566