Healthcare Provider Details

I. General information

NPI: 1417133430
Provider Name (Legal Business Name): ORCHARD VIEW PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 11/30/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12150 30 MILE RD STE 104
WASHINGTON TWP MI
48095
US

IV. Provider business mailing address

12150 30 MILE RD STE 104
WASHINGTON TWP MI
48095
US

V. Phone/Fax

Practice location:
  • Phone: 586-336-9552
  • Fax: 586-336-9583
Mailing address:
  • Phone: 586-336-9552
  • Fax: 586-336-9583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301008784
License Number StateMI

VIII. Authorized Official

Name: MR. PHILIP V. SAYWRAYNE JR.
Title or Position: MEMBER/OWNER
Credential:
Phone: 313-510-3313