Organization
KD PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN DEJONGH (PRESIDENT OF OPERATIONS)
(248) 540-8066
Entity
Organization
Contact information
Practice address
3130 GRATIOT AVE, DETROIT, MI 48207-2283
(313) 924-0092
(313) 924-0118
Mailing address
2520 INDUSTRIAL ROW DR, TROY, MI 48084-7035
(248) 540-8066
(248) 540-0112
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5301007358
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184617912
NPI
MI
01
—
2362616
NCPDP
MI
05
—
2362616
—
MI
Enumeration date
08/26/2005
Last updated
02/12/2009
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