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General NPI Number Information
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NPI Number | 1922690064
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Entity Type | Organization
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Legal Business Name | FENTON PHARMACY LLC
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Dates
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Enumeration Date | 02/10/2021
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 305 N LEROY ST STE A
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City | FENTON
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State | MI
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Zip | 48430-2729
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Country | US
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Telephone | 810-354-8500
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Fax | 810-354-5803
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Provider Business Mailing Address
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Address Line | 305 N LEROY ST STE A
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City | FENTON
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State | MI
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Zip | 48430-2729
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Country | US
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Telephone | 810-354-8500
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Fax | 810-354-5803
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Authorized Official
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Title or Position | PHARMACY OWNER
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Name | MANISH PATEL
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Credential |
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Telephone | 810-354-5800
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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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