Organization
GRAND VALUE PHARMACY INC
Active
Other names
GRAND VALUE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN WHITE RPH (OWNER PHARMACIST)
(313) 931-0010
Entity
Organization
Contact information
Practice address
10920 GRAND RIVER AVE, DETROIT, MI 48204-2052
(313) 931-0010
(313) 934-1658
Mailing address
10920 GRAND RIVER AVE, DETROIT, MI 48204-2052
(313) 931-0010
(313) 934-1658
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
530100439
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2043099
PK
—
05
—
3015348
—
MI
Enumeration date
10/07/2006
Last updated
10/20/2016
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