Organization
1616 FORD AVE DRUGS INC
Active
Other names
Wyandotte Action Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETAR DIMOVICH R.PH. (VICE PRESIDENT)
(734) 285-3111
Entity
Organization
Contact information
Practice address
1616 FORD AVE, WYANDOTTE, MI 48192-2304
(734) 285-3111
(734) 285-8258
Mailing address
1616 FORD AVE, WYANDOTTE, MI 48192-2304
(734) 285-3111
(734) 285-8258
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301006574
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2356978
NCPDP
MI
05
—
2356978
—
MI
Enumeration date
08/18/2006
Last updated
08/22/2020
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