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General NPI Number Information
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NPI Number | 1154841526
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Entity Type | Organization
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Legal Business Name | ALLIANCE SPECIALTY PHARMACY LLC
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Dates
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Enumeration Date | 06/26/2017
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Last Update Date | 11/01/2017
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Provider Practice Location Address
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Address Line | 25301 VAN DYKE AVE
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City | CENTER LINE
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State | MI
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Zip | 48015-1425
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Country | US
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Telephone | 248-230-8044
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Fax | 248-230-8045
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Provider Business Mailing Address
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Address Line | 25301 VAN DYKE AVE
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City | CENTER LINE
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State | MI
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Zip | 48015-1425
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Country | US
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Telephone | 248-230-8044
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Fax | 248-230-8045
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Authorized Official
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Title or Position | PHARMACY MANAGER/OWNER
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Name | PRITESH RAY
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Credential | PHARMD
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Telephone | 248-230-8044
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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 |
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License Number State |
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