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Organization
PRESCRIPTIONGIANT LLC
Active
Organization
PRESCRIPTIONGIANT LLC
Active
Other names
PRESCRIPTIONGIANT
Organization subpart
No
Provider details
NPI number
Authorized official
TYRONE SQUIRES MBA (OWNER)
(866) 499-1940
Entity
Organization
Contact information
Practice address
1078 E AVON RD, STE 221, ROCHESTER HILLS, MI 48307-2424
(866) 499-1940
(248) 608-6418
Mailing address
2620 CENTENNIAL RD STE G, TOLEDO, OH 43617-1800
(866) 499-1940
(248) 608-6418
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
Primary
021957250
OH
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2366929
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
2366929
—
MI
Enumeration date
10/03/2006
Last updated
06/22/2009
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