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General NPI Number Information
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NPI Number | 1043543200
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Entity Type | Organization
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Legal Business Name | GREENFIELD MEDICAL PHARMACY LLC
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Dates
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Enumeration Date | 09/04/2009
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 24261 GREENFIELD RD
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3117
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Country | US
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Telephone | 248-395-9790
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Fax | 248-395-9793
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Provider Business Mailing Address
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Address Line | 24261 GREENFIELD RD
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3117
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Country | US
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Telephone | 248-395-9790
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Fax | 248-395-9793
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Authorized Official
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Title or Position | PIC
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Name | MUHAMMAD RAMZAN
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Credential | RPH
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Telephone | 248-395-9790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301009189
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License Number State | MI
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