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General NPI Number Information
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NPI Number | 1972926293
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Entity Type | Organization
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Legal Business Name | TRI COUNTY PHARMACY INC.
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Dates
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Enumeration Date | 01/22/2014
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Last Update Date | 02/18/2014
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Provider Practice Location Address
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Address Line | 50 N PERRY ST EAST TOWER, SUITE 105
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City | PONTIAC
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State | MI
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Zip | 48342-2217
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Country | US
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Telephone | 734-624-7808
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Fax |
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Provider Business Mailing Address
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Address Line | 50 N PERRY ST EAST TOWER, SUITE 105
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City | PONTIAC
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State | MI
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Zip | 48342-2217
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Country | US
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Telephone | 734-624-7808
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MOBIN UDDIN
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Credential |
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Telephone | 734-624-7808
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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 | 5301010290
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 5301010290
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License Number State | MI
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