Organization
PINE KNOB PHARMACY #4
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY JAY PLAS PHARM.D. (MANAGER)
(248) 620-0296
Entity
Organization
Contact information
Practice address
5710 BELLA ROSA BLVD, CLARKSTON, MI 48348-4773
(248) 620-0296
Mailing address
5710 BELLA ROSA BLVD, CLARKSTON, MI 48348-4773
(248) 620-0296
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/06/2008
Last updated
02/06/2008
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