Organization
STP REX LLC
Active
Other names
Rexall Detroit Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CANDI TOLF (3RD PARTY COORDINATOR)
(248) 963-7979
Entity
Organization
Contact information
Practice address
9934 HARPER AVE, DETROIT, MI 48213-3110
(313) 921-3536
Mailing address
4301 ORCHARD LAKE RD STE 180-183, WEST BLOOMFIELD, MI 48323-1604
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FSRX9938785
FLEXSCRIPT
—
Enumeration date
11/08/2020
Last updated
09/20/2023
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