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Organization

DEROSSI S PHARMACY LLC

Active
Other names
DeRossi's Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
SACHIN PATEL (PRESIDENT)
(734) 246-8800
Entity
Organization

Contact information

Practice address
15348 FORT ST, SOUTHGATE, MI 48195-1304
(734) 246-8800
(734) 246-8808
Mailing address
15348 FORT ST, SOUTHGATE, MI 48195-1304
(734) 246-8800
(734) 246-8808

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
5301009569
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2375497
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
05/02/2011
Last updated
05/20/2011
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