Organization
FREEDOM APOTHECARY III INC
Active
Organization
FREEDOM APOTHECARY III INC
Active
Other names
NEW BOSTON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA TJOLSEN RPH (VP AND PHARM)
(735) 753-9480
Entity
Organization
Contact information
Practice address
19162 HURON RIVER DR, NEW BOSTON, MI 48164-9727
(734) 753-9480
(734) 753-5397
Mailing address
PO BOX 691, NEW BOSTON, MI 48164-0691
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301008319
MI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2368062
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/30/2006
Last updated
04/09/2008
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