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Organization
MADISON COMMUNITY HOSPITAL INC
Active
Organization
MADISON COMMUNITY HOSPITAL INC
Active
Other names
THE BEHAVIORAL CENTER OF MICHIGAN HOSPITAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN GUNABALAN (EXECT ADMIN)
(586) 261-2266
Entity
Organization
Contact information
Practice address
4050 E 12 MILE RD, WARREN, MI 48092-2534
(586) 261-2266
(586) 582-9570
Mailing address
4050 E 12 MILE RD, WARREN, MI 48092-2534
(586) 261-2266
(586) 582-9570
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
5301008786
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2043619
PK
—
Enumeration date
01/29/2008
Last updated
07/15/2013
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