Organization
BORMANS INC
Active
Other names
FARMER JACK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN KIJOWSKI (PHARMACY SPECIALIST)
(201) 571-8326
Entity
Organization
Contact information
Practice address
19195 LIVERNOIS AVE, DETROIT, MI 48221-1715
(313) 862-8017
(313) 862-2443
Mailing address
19195 LIVERNOIS AVE, DETROIT, MI 48221-1715
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301004524
MI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2337409
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
2798059
—
MI
Enumeration date
07/13/2006
Last updated
09/11/2025
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