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General NPI Number Information
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NPI Number | 1952543399
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Entity Type | Organization
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Legal Business Name | ONECARE RX LLC
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Dates
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Enumeration Date | 03/31/2009
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Last Update Date | 10/22/2009
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Provider Practice Location Address
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Address Line | 7375 SECOR RD SUITE A
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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 | PHARMACIST/OWNER
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Name | HANY BOUTROS
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Credential |
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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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 5301009187
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License Number State | MI
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