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General NPI Number Information
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NPI Number | 1659648749
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Entity Type | Organization
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Legal Business Name | CHEMVILLE PHARMACY INC
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Dates
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Enumeration Date | 11/17/2011
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Last Update Date | 11/17/2014
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Provider Practice Location Address
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Address Line | 22100 W 10 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3232
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Country | US
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Telephone | 248-356-2000
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Fax | 248-356-2022
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Provider Business Mailing Address
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Address Line | 22100 W 10 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3232
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Country | US
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Telephone | 248-356-2000
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Fax | 248-356-2022
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Authorized Official
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Title or Position | CEO/PHARMACIST
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Name | MAUREEN UZORKA
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Credential |
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Telephone | 586-764-9019
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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 | 5301009698
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License Number State | MI
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