=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609359496
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ERO PARTNERS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2018
-----------------------------------------------------
Last Update Date | 04/01/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14976 E 10 MILE RD
-----------------------------------------------------
City | EASTPOINTE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48021-1004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-933-1583
-----------------------------------------------------
Fax | 586-933-5026
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14976 E 10 MILE RD
-----------------------------------------------------
City | EASTPOINTE
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48021-1004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-933-1583
-----------------------------------------------------
Fax | 586-933-5026
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AO/OWNER
-----------------------------------------------------
Name | ANTHONY ASMAR
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 586-933-1583
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------