Organization
JOHN S LTC PHARMACY INC
Active
Other names
Shelby Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RASHUNTE BROWN (PHARMACIST)
(586) 461-2900
Entity
Organization
Contact information
Practice address
48887 HAYES RD, SHELBY TOWNSHIP, MI 48315-4405
(586) 461-2900
(586) 461-2464
Mailing address
48887 HAYES RD, SHELBY TOWNSHIP, MI 48315-4405
(586) 461-2900
(586) 461-2464
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010783
MI
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275998205
—
MI
01
—
2156098
PK
—
Enumeration date
12/17/2015
Last updated
10/20/2020
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