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General NPI Number Information
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NPI Number | 1255679924
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Entity Type | Organization
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Legal Business Name | BENSTAR PHARMACY PLLC
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | 2510 E NEVADA ST
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City | DETROIT
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State | MI
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Zip | 48234-1461
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Country | US
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Telephone | 313-334-5859
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Fax | 313-733-6115
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Provider Business Mailing Address
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Address Line | 2510 E NEVADA ST
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City | DETROIT
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State | MI
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Zip | 48234-1461
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Country | US
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Telephone | 313-334-5859
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Fax | 313-733-6115
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Authorized Official
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Title or Position | SUPT. PHARMACIST/MANAGER
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Name | UZOMA NWACHUKWU
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Credential |
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Telephone | 313-995-2747
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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 | 5301010006
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License Number State | MI
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