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General NPI Number Information
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NPI Number | 1821049891
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Entity Type | Organization
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Legal Business Name | PHARMAP LLC
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 15600 W 10 MILE RD UNIT 1B
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2147
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Country | US
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Telephone | 248-569-7578
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Fax | 248-569-7868
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Provider Business Mailing Address
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Address Line | 15600 W 10 MILE RD UNIT 1B
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2147
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Country | US
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Telephone | 248-569-7578
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Fax | 248-569-7868
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Authorized Official
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Title or Position | EVP
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Name | YVONNE GALLAGHER
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Credential |
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Telephone | 248-348-1570
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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 | 5301008385
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License Number State | MI
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