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General NPI Number Information
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NPI Number | 1003086141
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Entity Type | Organization
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Legal Business Name | HERITAGE PHARMACY INC
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 14709 CHAMPAIGN RD
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City | ALLEN PARK
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State | MI
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Zip | 48101-1616
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Country | US
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Telephone | 313-386-1200
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Fax | 313-386-0856
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Provider Business Mailing Address
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Address Line | 14709 CHAMPAIGN RD
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City | ALLEN PARK
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State | MI
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Zip | 48101-1616
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Country | US
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Telephone | 313-386-1200
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Fax | 313-386-0856
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GREGORY PAPP
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Credential |
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Telephone | 313-386-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | MI
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