Organization
MILLER ROAD PHARMACY
Active
Other names
MEDPHARM LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ABUSUFIAN ELTAIB ELTAHIR PHARMD (PHARMACY MANAGER)
(810) 228-3304
Entity
Organization
Contact information
Practice address
5097 MILLER RD, FLINT, MI 48507-1043
(810) 228-3304
(810) 228-3307
Mailing address
5097 MILLER RD, FLINT, MI 48507-1043
(810) 228-3304
(810) 228-3307
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301010651
MI
3336L0003X
Long Term Care Pharmacy
5301010651
MI
3336S0011X
Specialty Pharmacy
5301010651
MI
Other
Enumeration date
03/31/2015
Last updated
04/30/2015
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