Organization
BSW PHARMACY SERVICES LLC
Active
Organization
BSW PHARMACY SERVICES LLC
Active
Other names
WAYNE PROFESSIONAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINICK RUTHERFORD (PHARMACIST IN CHARGE)
(734) 728-8306
Entity
Organization
Contact information
Practice address
34841 VETERANS PLZ, WAYNE, MI 48184-1733
(734) 728-8306
(734) 728-8506
Mailing address
34841 VETERANS PLZ, WAYNE, MI 48184-1733
(734) 728-8306
(734) 728-8506
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009995
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138536
PK
—
Enumeration date
01/15/2013
Last updated
08/29/2022
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