Organization
PRINCES PHARMACY LLC
Active
Other names
Princes Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DUMAN SERGEY (OWNER)
(609) 772-1314
Entity
Organization
Contact information
Practice address
26190 OUTER DR STE 120, LINCOLN PARK, MI 48146-2084
(313) 887-7443
(313) 879-6929
Mailing address
26190 OUTER DR STE 120, LINCOLN PARK, MI 48146-2084
(313) 887-7443
(313) 879-6929
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010886
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063872034
—
MI
01
—
2158419
PK
—
Enumeration date
03/03/2016
Last updated
01/22/2021
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