Organization
SELECT CARE PHARMACY LLC
Active
Other names
Select Care Pharmacy, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
VIRENDRA GAIDHANE (CEO/AO)
(248) 246-7997
Entity
Organization
Contact information
Practice address
28003 JOHN R RD, MADISON HEIGHTS, MI 48071-2809
(248) 246-7997
(245) 565-2029
Mailing address
28003 JOHN R RD, MADISON HEIGHTS, MI 48071-2809
(248) 246-7997
(245) 565-2029
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010943
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2160107
PK
—
05
—
82265105
—
MI
Enumeration date
05/11/2016
Last updated
12/22/2016
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