MEDICARE: FRENCHTOWN RX LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	5301011118	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FSRX8363084	OTHER		FLEXSCRIPT

General Provider Information

NPI Number	:	1023556834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRENCHTOWN RX LLC

Provider Business Mailing Address
First Line	:	4301 ORCHARD LAKE RD STE 180-183
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-1604
Country	:	US
Telephone Number	:	248-963-7979
Fax Number	:

Provider Business Practice Location Address
First Line	:	7505 GRAFTON RD STE 2
Second Line	:
City	:	NEWPORT
State	:	MI
Zip	:	48166-8939
Country	:	US
Telephone Number	:	734-872-2100
Fax Number	:	734-872-2101

Authorized Official
Title or Position	:	3RD PARTY COORDINATOR
Name	:	CANDI TOLF
Credential	:
Telephone Number	:	248-963-7979

Provider Enumeration Date	:	02/01/2017
Last Update Date	:	09/20/2023

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Directions to “FRENCHTOWN RX LLC ” Practice Location

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