Organization
BELLEVILLE NEIGHBORHOOD PHARMACY
Active
Organization
BELLEVILLE NEIGHBORHOOD PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMEKA BACON (MANG)
(734) 649-0762
Entity
Organization
Contact information
Practice address
887 SUMPTER RD, STE A, BELLEVILLE, MI 48111-4905
(734) 699-7904
(734) 699-7914
Mailing address
887 SUMPTER RD, STE A, BELLEVILLE, MI 48111-4905
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301008744
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2370485
OTHER ID NUMBER
—
Enumeration date
11/24/2007
Last updated
12/04/2007
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