Organization
KNAB PHARMACY INC
Active
Other names
wiltse's community pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. D D KNAB PHARMACIST (PRESIDENT)
(734) 453-4848
Entity
Organization
Contact information
Practice address
330 S MAIN ST, PLYMOUTH, MI 48170-1604
(734) 453-4848
(734) 453-4090
Mailing address
330 S MAIN ST, PLYMOUTH, MI 48170-1604
(734) 453-4848
(734) 453-4090
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301000965
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2310643
—
MI
Enumeration date
08/11/2005
Last updated
12/21/2015
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