Organization
PRESTIGE SPECIALTY PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL CYPRUS (MEMBER)
(313) 289-7878
Entity
Organization
Contact information
Practice address
3739 15 MILE RD, STERLING HEIGHTS, MI 48310
(877) 742-7621
(586) 883-9388
Mailing address
3739 15 MILE RD, STERLING HEIGHTS, MI 48310
(877) 742-7621
(586) 883-9388
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
MI
Other
Enumeration date
03/20/2018
Last updated
03/17/2023
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