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General NPI Number Information
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NPI Number | 1972140499
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Entity Type | Organization
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Legal Business Name | VILLAGE PHARMACY COMPOUNDING 3 INC
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Dates
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Enumeration Date | 12/03/2019
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Last Update Date | 08/25/2020
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Provider Practice Location Address
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Address Line | 31213 SOUTHFIELD RD
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City | BEVERLY HILLS
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State | MI
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Zip | 48025-5455
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Country | US
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Telephone | 248-723-4444
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Fax | 248-723-3910
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Provider Business Mailing Address
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Address Line | 31213 SOUTHFIELD RD
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City | BEVERLY HILLS
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State | MI
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Zip | 48025-5455
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Country | US
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Telephone | 248-723-4444
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Fax | 248-723-3910
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Authorized Official
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Title or Position | OWNER
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Name | GABLAN ZAWAIDEH
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Credential |
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Telephone | 248-723-4444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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