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General NPI Number Information
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NPI Number | 1023312667
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Entity Type | Organization
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Legal Business Name | DORT PHARMACY LLC
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Dates
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Enumeration Date | 12/22/2010
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Last Update Date | 02/22/2011
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Provider Practice Location Address
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Address Line | 915 S DORT HWY
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City | FLINT
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State | MI
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Zip | 48503-2800
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Country | US
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Telephone | 810-233-5900
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Fax | 810-233-5901
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Provider Business Mailing Address
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Address Line | PO BOX 48
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City | FLINT
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State | MI
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Zip | 48501-0048
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Country | US
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Telephone | 810-444-4048
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Fax | 810-233-5901
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Authorized Official
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Title or Position | PHARMACIST
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Name | HITESH PATEL
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Credential |
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Telephone | 810-444-4048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301009470
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License Number State | MI
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