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General NPI Number Information
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NPI Number | 1760960603
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Entity Type | Organization
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Legal Business Name | ALPHABETA PHARMACY, LLC
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Dates
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Enumeration Date | 08/02/2018
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 1191 N MILFORD RD
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City | MILFORD
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State | MI
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Zip | 48381-1050
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Country | US
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Telephone | 248-685-8363
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Fax |
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Provider Business Mailing Address
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Address Line | 4301 ORCHARD LAKE RD STE 180-183
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48323-1604
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Country | US
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Telephone | 810-772-7979
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | ANTHONY ASMAR
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Credential |
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Telephone | 810-772-7979
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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 | 5301007695
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License Number State | MI
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