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General NPI Number Information
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NPI Number | 1912898081
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Entity Type | Organization
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Legal Business Name | PARKVIEWRX MICHIGAN LLC
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 211 N SHIAWASSEE ST
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City | CORUNNA
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State | MI
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Zip | 48817-1444
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Country | US
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Telephone | 989-720-4295
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Fax |
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Provider Business Mailing Address
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Address Line | 3920 MAIN ST STE 100
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City | BUFFALO
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State | NY
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Zip | 14226-3350
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | JUSTIN WACLAWEK
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Credential |
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Telephone | 716-876-2323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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