Organization
BUCKLEY BRANDS LLC
Active
Other names
Buckley's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY COLE PHARMD (MANAGING MEMBER)
(313) 971-5030
Entity
Organization
Contact information
Practice address
18021 CONANT ST, DETROIT, MI 48234
(313) 368-1000
(313) 368-1068
Mailing address
18021 CONANT ST, DETROIT, MI 48234
(313) 368-1000
(313) 368-1068
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009538
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2365600
—
MI
01
—
2375283
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/24/2011
Last updated
01/14/2013
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