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Organization

ST JOSEPH MERCY PROFESSIONAL PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PHILLIP J WEIN PHARMACIST (MANAGER, PHARMACY SERVICES)
(248) 858-3053
Entity
Organization

Contact information

Practice address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 452-5357
(248) 452-5292
Mailing address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 858-3053
(248) 858-3010

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
5301007139
MI
3336H0001X
Home Infusion Therapy Pharmacy
5301007139
MI
3336S0011X
Specialty Pharmacy
Primary
5301007139
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2360876
NABP/NCPDP #
MI
05
4168904
MI
05
4168922
MI
01
5301007139
MICHIGAN LICENSE #
MI
Enumeration date
10/05/2006
Last updated
09/11/2025
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