Organization
FENTON PHARMACY LLC
Active
Other names
Fenton Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MANISH PATEL (OWNER)
(813) 304-2221
Entity
Organization
Contact information
Practice address
305 N LEROY ST STE A, FENTON, MI 48430-2729
(810) 354-8500
(810) 354-8503
Mailing address
305 N. LEROY ST, SUITE A, FENTON, MI 48430
(810) 354-8500
(810) 354-8503
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010093
MI
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140350
PK
—
Enumeration date
05/14/2013
Last updated
05/30/2023
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