Organization
HIGHLAND ROAD PLAZA LLC
Active
Other names
Jai Chamunda, inc, jai chamunda morenci, Inc, Mike Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
GEBRE ASHEBIR (MANAGER)
(571) 274-1037
Entity
Organization
Contact information
Practice address
213 W MAIN ST, MORENCI, MI 49256-1420
(517) 458-2261
(517) 458-7758
Mailing address
6479 WYNDHAM DR, WEST BLOOMFIELD, MI 48322-1070
(517) 458-2261
(517) 458-7758
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301001291
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2334794
OTHER ID NUMBER
—
01
—
MI3179
PTAN
MI
Enumeration date
01/04/2007
Last updated
02/17/2025
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