Organization
BINGHAM PHARMACY LLC
Active
Other names
BINGHAM PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
GEETIKA GOSWAMI (PRESIDENT)
(617) 309-8064
Entity
Organization
Contact information
Practice address
7825 N DIXIE HWY STE 105, NEWPORT, MI 48166-9750
(734) 789-8957
Mailing address
7825 N DIXIE HWY, SUITE#105, NEWPORT, MI 48166-9750
(734) 789-8957
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010056
MI
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2377869
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/25/2013
Last updated
03/25/2013
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