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General NPI Number Information
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NPI Number | 1881703569
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Entity Type | Organization
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Legal Business Name | H&P FOODTOWN PHARMACY, INC
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 04/16/2009
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Provider Practice Location Address
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Address Line | 7375 SECOR RD
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City | LAMBERTVILLE
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State | MI
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Zip | 48144-9737
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Country | US
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Telephone | 734-856-3113
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Fax | 734-854-4936
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Provider Business Mailing Address
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Address Line | PO BOX 796
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City | LAMBERTVILLE
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State | MI
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Zip | 48144-0796
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Country | US
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Telephone | 734-856-3113
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Fax | 734-854-4936
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Authorized Official
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Title or Position | OWNER
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Name | MR. HANY BOUTROS
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Credential | RPH
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Telephone | 734-856-3113
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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 | 5301007970
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License Number State | MI
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