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General NPI Number Information
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NPI Number | 1922895010
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Entity Type | Organization
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Legal Business Name | ALGONAC PHARMACY
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 423 MICHIGAN ST
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City | ALGONAC
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State | MI
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Zip | 48001-1641
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Country | US
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Telephone | 810-671-2102
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Fax |
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Provider Business Mailing Address
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Address Line | 15784 REGENT ST
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City | MACOMB
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State | MI
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Zip | 48044-1535
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Country | US
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Telephone | 313-407-2171
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MR. DIVYESHKUMAR V PATEL
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Credential | PHARM. D
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Telephone | 313-407-2171
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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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