Organization
PAUL ROTARIUS INC
Active
Other names
Grand River Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL ROTARIUS (PRESIDENT)
(313) 533-0560
Entity
Organization
Contact information
Practice address
19460 GRAND RIVER AVE, DETROIT, MI 48223-1200
(313) 533-0560
(313) 533-0568
Mailing address
19460 GRAND RIVER AVE, DETROIT, MI 48223-1200
(313) 533-0560
(313) 533-0568
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009114
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2373215
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/23/2009
Last updated
12/02/2009
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