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General NPI Number Information
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NPI Number | 1689625873
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Entity Type | Organization
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Legal Business Name | KNIGHT DRUGS MADISON HEIGHTS
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Dates
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Enumeration Date | 05/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1385 E 12 MILE RD
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-2602
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Country | US
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Telephone | 248-399-2800
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Fax | 248-399-2062
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Provider Business Mailing Address
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Address Line | 1385 E 12 MILE RD
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-2602
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Country | US
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Telephone | 248-399-2800
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Fax | 248-399-2062
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Authorized Official
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Title or Position | PRESIDENT
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Name | GERALD BORSAND
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Credential |
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Telephone | 248-540-8066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5301008188
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License Number State | MI
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