Organization
BORMANS INC
Active
Other names
FARMER JACK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN KIJOWSKI (PHARMACY SPECIALIST)
(201) 571-8326
Entity
Organization
Contact information
Practice address
1380 N LEROY ST, FENTON, MI 48430-2762
(810) 750-5558
(810) 750-5562
Mailing address
1380 N LEROY ST, FENTON, MI 48430-2762
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301006583
MI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2356942
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
3356946
—
MI
Enumeration date
07/13/2006
Last updated
09/11/2025
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