Organization
PROFESSIONAL VILLAGE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BICKING RPH (OWNER)
(734) 243-5656
Entity
Organization
Contact information
Practice address
128 COLE RD STE B, MONROE, MI 48162-4104
(734) 457-2211
(734) 457-3738
Mailing address
128 COLE RD STE B, MONROE, MI 48162-4104
(734) 457-2211
(734) 457-3738
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
5301006995
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4103884
—
MI
Enumeration date
05/04/2006
Last updated
08/22/2020
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