Organization
CET PHARMACY GRAND RAPIDS LLC
Active
Other names
CET Pharmacy 1005
Organization subpart
No
Provider details
NPI number
Authorized official
CHADI AZZI RPH (OWNER)
(248) 818-0766
Entity
Organization
Contact information
Practice address
2060 E PARIS AVE SE STE 110, GRAND RAPIDS, MI 49546-6113
(616) 957-9191
(616) 957-9160
Mailing address
504 MAIN ST, BELLEVILLE, MI 48111-5600
(616) 957-9191
(616) 957-9160
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301010112
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073950994
—
MI
01
—
2140605
PK
—
Enumeration date
06/01/2013
Last updated
12/31/2014
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