Individual
ANDREW J MAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
34550 GLENDALE ST, LIVONIA, MI 48150-1304
(734) 377-3154
(734) 345-3525
Mailing address
32320 5 MILE RD, LIVONIA, MI 48154-6109
(734) 353-7809
(888) 722-5579
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302028280
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302028280
MICHIGAN CONTROLLED SUBSTANCE LICENSE
MI
Enumeration date
05/06/2008
Last updated
01/21/2022
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