Organization
O2 PHARMACY, LLC
Active
Other names
o2 Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS CHINCHILLA (OWNER)
(888) 224-3081
Entity
Organization
Contact information
Practice address
39765 GRAND RIVER AVE, NOVI, MI 48375
(248) 987-2024
(248) 987-6998
Mailing address
39765 GRAND RIVER AVE, NOVI, MI 48375-2107
(248) 987-2024
(248) 987-6998
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301011378
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177506
PK
—
Enumeration date
04/30/2018
Last updated
04/15/2020
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