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General NPI Number Information
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NPI Number | 1649794231
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Entity Type | Organization
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Legal Business Name | SCRIPT SHOP BLOOMFIELD LLC
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 1060 W HURON ST
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City | WATERFORD
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State | MI
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Zip | 48328-3730
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Country | US
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Telephone | 877-910-4515
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Fax | 248-721-8582
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Provider Business Mailing Address
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Address Line | 1060 W HURON ST
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City | WATERFORD
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State | MI
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Zip | 48328-3730
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Country | US
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Telephone | 877-910-4515
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Fax | 248-721-8582
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Authorized Official
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Title or Position | OWNER
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Name | THOMAS KATO
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Credential |
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Telephone | 305-487-1000
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5315072866
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License Number State | MI
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