Organization
REDFORD DISCOUNT PHARMACY PLLC
Active
Other names
REDFORD DISCOUNT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
IKENNA DURU (MANAGER)
(313) 533-7920
Entity
Organization
Contact information
Practice address
25850 GRAND RIVER AVE, REDFORD, MI 48240-1433
(313) 533-7920
(313) 533-7923
Mailing address
25850 GRAND RIVER, REDFORD, MI 48240
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009091
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2372732
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/05/2009
Last updated
05/05/2009
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