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General NPI Number Information
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NPI Number | 1346766672
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Entity Type | Organization
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Legal Business Name | CORSOCARE PHARMACY SERVICES LLC
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Dates
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Enumeration Date | 08/17/2017
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Last Update Date | 09/09/2017
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Provider Practice Location Address
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Address Line | 41200 BRIDGE ST
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City | NOVI
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State | MI
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Zip | 48375-1301
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Country | US
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Telephone | 734-353-7809
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Fax |
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Provider Business Mailing Address
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Address Line | 41200 BRIDGE ST
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City | NOVI
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State | MI
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Zip | 48375-1301
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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 | PHARMACIST IN CHARGE
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Name | ANDREW MAC
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Credential | RPH
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Telephone | 734-353-7809
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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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