Organization
CANTON SPECIALTY PHARMACY LLC
Active
Other names
Canton Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DIAA BERRY RPH (SOLE MEMBER/PHARMACIST)
(734) 259-6700
Entity
Organization
Contact information
Practice address
305 N LILLEY RD, CANTON, MI 48187-3908
(734) 259-6700
(734) 259-6707
Mailing address
305 N LILLEY RD, CANTON, MI 48187-3908
(734) 259-6700
(734) 259-6707
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009443
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2125886
PK
—
Enumeration date
07/20/2010
Last updated
10/15/2015
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