Healthcare Provider Details

I. General information

NPI: 1477263564
Provider Name (Legal Business Name): VITAMED PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2022
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 S MERRIMAN RD
WESTLAND MI
48186-5301
US

IV. Provider business mailing address

1629 S MERRIMAN RD
WESTLAND MI
48186-5301
US

V. Phone/Fax

Practice location:
  • Phone: 734-822-9600
  • Fax: 734-822-9666
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. CHIRAG PATEL
Title or Position: MANAGER
Credential: CPHT
Phone: 734-822-9600