Healthcare Provider Details

I. General information

NPI: 1437716958
Provider Name (Legal Business Name): APOLLO PHARMACY OF WYANDOTTE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2019
Last Update Date: 08/17/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 EUREKA RD
WYANDOTTE MI
48192-6004
US

IV. Provider business mailing address

2000 EUREKA RD
WYANDOTTE MI
48192-6004
US

V. Phone/Fax

Practice location:
  • Phone: 734-674-1452
  • Fax:
Mailing address:
  • Phone: 734-550-0850
  • Fax: 734-562-4584

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 Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. NEHAL PATEL
Title or Position: PRESIDENT
Credential:
Phone: 734-550-0850