Healthcare Provider Details
I. General information
NPI: 1093258915
Provider Name (Legal Business Name): PCS PHARMACEUTICALS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/25/2016
Last Update Date: 01/13/2024
Certification Date: 01/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27472 SCHOENHERR RD STE 1OO
WARREN MI
48088-6688
US
IV. Provider business mailing address
801 S ADAMS RD SUITE 204
BIRMINGHAM MI
48009-7016
US
V. Phone/Fax
- Phone: 248-289-7054
- Fax: 248-289-7102
- Phone: 248-289-7054
- Fax: 248-289-7102
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 5301011067 |
| License Number State | MI |
VIII. Authorized Official
Name:
KAMIL
SABA
Title or Position: PHARMACIST
Credential:
Phone: 248-289-7054