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General NPI Number Information
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NPI Number | 1831465863
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Entity Type | Organization
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Legal Business Name | COUNTY PHARMACY SERVICES PLLC
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Dates
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Enumeration Date | 03/23/2012
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 6 W MICHIGAN AVE
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City | YPSILANTI
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State | MI
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Zip | 48197-5437
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Country | US
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Telephone | 734-477-9006
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Fax | 734-477-9012
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Provider Business Mailing Address
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Address Line | 6 W MICHIGAN AVE
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City | YPSILANTI
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State | MI
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Zip | 48197-5437
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Country | US
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Telephone | 734-477-9006
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Fax | 734-477-9012
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | LAURA BERNARD
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Credential |
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Telephone | 734-477-9006
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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 | 5301009781
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License Number State | MI
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