Organization
AJC ENTERPRISES INC
Active
Other names
MEDICAP PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY J CRACCHIOLO RPH (OWNER PHARMACIST)
(586) 582-9670
Entity
Organization
Contact information
Practice address
11460 E 12 MILE RD, WARREN, MI 48093-2631
(586) 582-9670
(586) 751-4122
Mailing address
11460 E 12 MILE RD, WARREN, MI 48093-2631
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301007110
MI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2357730
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/15/2006
Last updated
03/07/2023
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