Organization
DUNDEE PHARMACY SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY STIFF RPH (OWNER)
(734) 529-2246
Entity
Organization
Contact information
Practice address
115 RILEY ST, DUNDEE, MI 48131-1025
(734) 529-2246
(734) 529-5744
Mailing address
115 RILEY ST, DUNDEE, MI 48131-1025
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301007410
MI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2329349
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
2329349
—
MI
01
—
4904571
MEDICAID DME
MI
Enumeration date
05/23/2006
Last updated
10/23/2007
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