Organization
WALNUT ASSOCIATES I LLC
Active
Other names
WEST GRANGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM NEWMAN (CEO)
(248) 354-0282
Entity
Organization
Contact information
Practice address
3390 WEST ROAD, TRENTON, MI 48183
(734) 676-6622
(734) 676-5725
Mailing address
3390 WEST ROAD, TRENTON, MI 48183-2323
(734) 676-6622
(734) 676-5725
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301006407
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2308054
OTHER ID NUMBER
—
05
—
2308054
—
MI
Enumeration date
08/27/2006
Last updated
05/18/2018
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