Healthcare Provider Details

I. General information

NPI: 1598593634
Provider Name (Legal Business Name): RXALL PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14720 KING RD STE C
RIVERVIEW MI
48193-7975
US

IV. Provider business mailing address

14720 KING RD STE C
RIVERVIEW MI
48193-7975
US

V. Phone/Fax

Practice location:
  • Phone: 734-463-3300
  • Fax:
Mailing address:
  • Phone: 734-463-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: VISHAL NAYAK
Title or Position: MANAGER
Credential:
Phone: 734-463-3300