Organization
BLOOMFIELD PROFESSIONAL PHARMACY
Active
Other names
Oakland Hills Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD GHANNAM (TREASURER)
(248) 756-5123
Entity
Organization
Contact information
Practice address
2520 S TELEGRAPH RD, SUITE 100, BLOOMFIELD HILLS, MI 48302-0285
(248) 758-9490
(248) 758-9502
Mailing address
PO BOX 8039, BLOOMFIELD HILLS, MI 48302-8039
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009090
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2372629
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/09/2009
Last updated
04/28/2009
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