Organization
RED CROWN CLINIC PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC M GRAHAM RPH (PRESIDENT)
(269) 321-4800
Entity
Organization
Contact information
Practice address
4206 STADIUM DR, SUITE-2, KALAMAZOO, MI 49008-1446
(269) 321-4800
(269) 321-4801
Mailing address
4206 STADIUM DR, SUITE-2, KALAMAZOO, MI 49008-1446
(269) 321-4800
(269) 321-4801
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
5301008820
MI
3336L0003X
Long Term Care Pharmacy
Primary
5301008820
MI
3336S0011X
Specialty Pharmacy
5301008820
MI
Other
Enumeration date
01/28/2008
Last updated
03/18/2008
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