Organization
CET PHARMACY LTC LLC
Active
Other names
CET Pharmacy LTC
Organization subpart
No
Provider details
NPI number
Authorized official
EDDY AOUN (OFFICER)
(313) 525-2911
Entity
Organization
Contact information
Practice address
6140 28TH ST SE STE 105, GRAND RAPIDS, MI 49546-6938
(734) 796-1534
Mailing address
6140 28TH ST SE, STE 105, GRAND RAPIDS, MI 49546-6938
(734) 796-1534
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
5301010531
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146993
PK
—
Enumeration date
08/12/2014
Last updated
09/26/2014
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