MEDICARE: STATE PHARMACY

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	3336C0003X	Community/Retail Pharmacy	5301009540	MI

General Provider Information

NPI Number	:	1154610558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STATE PHARMACY

Provider Business Mailing Address
First Line	:	4501 WOODWARD AVE STE 104A
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48201-1890
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4501 WOODWARD AVE STE 104A
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48201-1890
Country	:	US
Telephone Number	:	313-832-4970
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KHUSHBOO PATEL
Credential	:
Telephone Number	:	810-280-7293

Provider Enumeration Date	:	04/06/2011
Last Update Date	:	04/06/2011

Similar Medicare Providers

1295728095 — KNIGHT PRESCRIPTION SERVICES
Practice Location Address:

4501 WOODWARD AVE , SUITE 104A
DETROIT, MI
48201-1890

Practice Phone: 313-832-5800
Practice Fax: 313-832-5802

1063883403 — WALGREEN CO
Practice Location Address:

4501 WOODWARD AVE , SUITE 105
DETROIT, MI
48201-1890

Practice Phone: 313-230-2170
Practice Fax: 312-230-2004

1376055079 — WOODWARD RX LLC
Practice Location Address:

4501 WOODWARD AVE
DETROIT, MI
48201-1890

Practice Phone: 313-832-5800
Practice Fax: 313-832-5802

1013528553 — ELIZABETH SANDERS
Practice Location Address:

4501 WOODWARD AVE STE 101
DETROIT, MI
48201-1890

Practice Phone: 131-357-0770
Practice Fax: 313-577-6137

1841186871 — CONVERSION CONTRACTING LLC
Practice Location Address:

20131 JAMES COUZENS FWY
DETROIT, MI
48235-1890

Practice Phone: 313-558-8499
Practice Fax:

1205230307 — THE VILLAGE HEALTH INITIATIVE
Practice Location Address:

1890 DETROIT AVE NW
ATLANTA, GA
30314-1638

Practice Phone: 404-671-4920
Practice Fax:

Directions to “STATE PHARMACY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.