Organization
DETROIT COMMUNITY HEALTH CONNECTION
Active
Other names
Detroit Community Health Connection Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE W BRADLEY SR. (PRESIDENT & CEO)
(313) 343-2891
Entity
Organization
Contact information
Practice address
7900 KERCHEVAL ST, DETROIT, MI 48214-2439
(313) 924-9798
(313) 924-6244
Mailing address
7900 KERCHEVAL STREET, DETROIT, MI 48214
(313) 924-9798
(313) 924-6244
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
5301008896
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679737480
—
MI
01
—
2116456
PK
—
Enumeration date
07/11/2008
Last updated
03/22/2019
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