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General NPI Number Information
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NPI Number | 1295341162
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Entity Type | Organization
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Legal Business Name | CENTRAL RX LLC
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 20733 E 13 MILE RD
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City | ROSEVILLE
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State | MI
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Zip | 48066-4503
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Country | US
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Telephone | 586-415-4844
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Fax |
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Provider Business Mailing Address
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Address Line | 20733 E 13 MILE RD
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City | ROSEVILLE
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State | MI
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Zip | 48066-4503
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Country | US
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Telephone | 586-415-4844
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Fax |
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Authorized Official
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Title or Position | PIC
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Name | FANAR JWAIDA
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Credential |
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Telephone | 248-762-0901
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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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