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Organization

MANOR PHARMACY & SURGICAL SUPPLY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL GERARD LEBRYK PHARMACIST (PHARMACIST/OWNER)
(313) 881-4480
Entity
Organization

Contact information

Practice address
20853 MACK AVE, GROSSE POINTE WOODS, MI 48236-1456
(313) 881-4480
(313) 881-7449
Mailing address
20853 MACK AVE, GROSSE POINTE WOODS, MI 48236-1456
(313) 881-4480
(313) 881-7449

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5302026288
MI
333600000X
Pharmacy
MI

Other

Enumeration date
08/19/2005
Last updated
03/25/2008
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