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General NPI Number Information
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NPI Number | 1134001449
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Entity Type | Organization
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Legal Business Name | HOLIDAY CARE PHARMACY LLC
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 25900 GREENFIELD RD STE 102
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City | OAK PARK
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State | MI
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Zip | 48237-4211
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Country | US
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Telephone | 248-701-2492
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Fax |
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Provider Business Mailing Address
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Address Line | 6443 INKSTER RD STE 170F
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48301-1320
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JASON SHANBAUM
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Credential |
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Telephone | 248-701-2492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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