Organization
MCNICHOLS DRUGSTORE LLC
Active
Other names
McNichols Drugstore
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAMI LAZEKI PHARM D (PHARMACIST IN CHARGE)
(313) 377-5626
Entity
Organization
Contact information
Practice address
10123 W MCNICHOLS RD, DETROIT, MI 48221-2454
(313) 340-4242
(313) 340-4445
Mailing address
10123 W MCNICHOLS RD, DETROIT, MICHIGAN 48221
(313) 340-4242
(313) 340-4445
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009824
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2376932
NCPDP
—
01
—
5301009824
STATE LISCENCE
MI
Enumeration date
07/10/2012
Last updated
03/07/2023
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