Organization
PRESCRIPTION GIANT LLC
Active
Other names
PRESCRIPTION GIANT
Organization subpart
No
Provider details
NPI number
Authorized official
TYRONE SQUIRES MBA (OWNER)
(586) 850-2256
Entity
Organization
Contact information
Practice address
4121 CLEAR SPRING CT, SHELBY TOWNSHIP, MI 48316-4028
(800) 497-9318
(586) 797-9612
Mailing address
2939 S ROCHESTER RD, STE 221, ROCHESTER HILLS, MI 48307-4552
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301007895
MI
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2366929
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/12/2006
Last updated
08/01/2008
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