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Organization
MI PHARM LLC
Active
Organization
MI PHARM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW J MAC R.PH. (PHARMACIST IN CHARGE)
(734) 744-4070
Entity
Organization
Contact information
Practice address
32320 5 MILE RD, LIVONIA, MI 48154-6109
(734) 744-4070
(866) 798-4070
Mailing address
32320 5 MILE RD, LIVONIA, MI 48154-6109
(734) 744-4070
(734) 744-4177
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
5301008682
MI
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2042755
PK
—
01
—
5301012858
MICHIGAN BOARD OF PHARMACY LICENSE
MI
01
—
5315231232
MICHIGAN BOARD OF PHARMACY CONTROLLED SUBSTANCE LICENSE
MI
Enumeration date
08/22/2007
Last updated
02/09/2023
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