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General NPI Number Information
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NPI Number | 1134509656
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Entity Type | Organization
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Legal Business Name | EPIC PHARMACY PLLC
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Dates
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Enumeration Date | 06/01/2015
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Last Update Date | 04/20/2018
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Provider Practice Location Address
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Address Line | 911 E 9 MILE RD
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City | FERNDALE
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State | MI
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Zip | 48220-1934
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Country | US
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Telephone | 248-309-6640
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Fax | 248-309-6644
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Provider Business Mailing Address
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Address Line | PO BOX 20280
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City | FERNDALE
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State | MI
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Zip | 48220-0280
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Country | US
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Telephone | 248-309-6640
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Fax | 248-309-6644
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | GREG NAMAN
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Credential |
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Telephone | 248-336-4000
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301010732
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License Number State | MI
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