Organization
GBOGBARA INC
Active
Parent organization
GBOGBARA INC
Other names
King Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
GBOGBARA INC
Authorized official
MR. LENYIE NGBOGBARA (PRESIDENT)
(313) 319-4444
Entity
Organization
Contact information
Practice address
28350 GRATIOT AVE, ROSEVILLE, MI 48066
(586) 218-8181
(586) 884-3488
Mailing address
28350 GRATIOT AVE, ROSEVILLE, MI 48066
(586) 218-8181
(586) 884-3488
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301010945
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2160295
PK
—
Enumeration date
05/26/2016
Last updated
12/09/2020
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