Organization
PROFESSIONAL PHARMACY SERVICES-II INC.
Active
Organization
PROFESSIONAL PHARMACY SERVICES-II INC.
Active
Other names
NORTHEAST PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WILCZYNSKI BS PHARMACY (STAFF)
(586) 263-6400
Entity
Organization
Contact information
Practice address
43900 GARFIELD RD, STE 102, CLINTON TWP, MI 48038-1128
(586) 263-6400
(586) 263-9463
Mailing address
43900 GARFIELD RD, STE 102, CLINTON TWP, MI 48038-1128
(586) 263-6400
(586) 263-9463
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301006929
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2044386
PK
—
05
—
2359544
—
MI
Enumeration date
06/17/2006
Last updated
04/06/2016
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