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General NPI Number Information
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NPI Number | 1457525818
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Entity Type | Organization
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Legal Business Name | SEAWAY PHARMACY , P.C.
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 08/25/2014
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Provider Practice Location Address
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Address Line | 8750 TELEGRAPH RD SUITE 104
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City | TAYLOR
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State | MI
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Zip | 48180-2397
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Country | US
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Telephone | 313-291-2182
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Fax | 313-291-2197
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Provider Business Mailing Address
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Address Line | 8750 TELEGRAPH RD SUITE 104
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City | TAYLOR
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State | MI
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Zip | 48180-2397
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Country | US
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Telephone | 313-291-2182
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Fax | 313-291-2197
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. RAAD KOUZA
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Credential | R. PH.
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Telephone | 734-323-1120
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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 | 5315034932
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License Number State | MI
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