Organization
GREAT AMERICAN ASSOCIATES LLC
Active
Other names
Grant Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONY JOHN KOKKATT PHARM D (PRESIDENT)
(248) 799-3900
Entity
Organization
Contact information
Practice address
29355 NORTHWESTERN HWY, STE 220, SOUTHFIELD, MI 48034-1053
(248) 799-3900
(248) 799-3992
Mailing address
29355 NORTHWESTERN HWY STE 220, SOUTHFIELD, MI 48034-1051
(248) 799-3900
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009932
MI
3336L0003X
Long Term Care Pharmacy
5301009932
MI
3336S0011X
Specialty Pharmacy
5301009932
MI
Other
Enumeration date
10/20/2012
Last updated
11/29/2016
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