Organization
PRATHER ENTERPRISES INC
Active
Other names
THE COMPOUND SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN PRATHER RPH (PRESIDENT)
(734) 243-2247
Entity
Organization
Contact information
Practice address
49 S MONROE ST, STE 150, MONROE, MI 48161-2476
(734) 243-2478
(734) 243-2479
Mailing address
49 S MONROE ST, STE 150, MONROE, MI 48161-2476
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
5301008860
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2371285
OTHER ID NUMBER
—
Enumeration date
06/10/2008
Last updated
06/10/2008
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