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General NPI Number Information
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NPI Number | 1649463712
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Entity Type | Organization
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Legal Business Name | MI PHARM LLC
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 02/09/2023
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Provider Practice Location Address
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Address Line | 32320 5 MILE RD
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City | LIVONIA
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State | MI
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Zip | 48154-6109
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Country | US
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Telephone | 734-744-4070
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Fax | 866-798-4070
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Provider Business Mailing Address
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Address Line | 32320 5 MILE RD
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City | LIVONIA
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State | MI
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Zip | 48154-6109
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Country | US
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Telephone | 734-744-4070
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Fax | 734-744-4177
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. ANDREW J MAC
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Credential | R.PH.
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Telephone | 734-744-4070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 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 #3
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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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Taxonomy #4
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 5301008682
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License Number State | MI
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