Healthcare Provider Details

I. General information

NPI: 1356362321
Provider Name (Legal Business Name): OHM SPECIALITY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 03/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 S 4TH AVE
SAGINAW MI
48607-1602
US

IV. Provider business mailing address

316 S 4TH AVE
SAGINAW MI
48607-1602
US

V. Phone/Fax

Practice location:
  • Phone: 989-758-6000
  • Fax: 989-758-6001
Mailing address:
  • Phone: 989-758-6000
  • Fax: 989-758-6001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301009061
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PARESH PATEL
Title or Position: PRESIDENT
Credential: R.PH
Phone: 336-918-6353