Organization
OMEGA PHARMACY LLC
Active
Other names
OMEGA PHARMACY II
Organization subpart
No
Provider details
NPI number
Authorized official
AYODEJI ABEJIDE (CEO)
(586) 945-1778
Entity
Organization
Contact information
Practice address
640 AUBURN AVE, PONTIAC, MI 48342-3365
(248) 481-2462
Mailing address
640 AUBURN AVE, PONTIAC, MI 48342-3365
(248) 481-2462
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010143
MI
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141640
PK
—
Enumeration date
08/12/2013
Last updated
06/25/2014
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