Organization
JBRX
Active
Organization
JBRX
Active
Other names
Lytle Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN BLANCHARD PHARMD (PIC/OWNER)
(248) 651-8511
Entity
Organization
Contact information
Practice address
340 S MAIN ST, 1, ROCHESTER, MI 48307-2030
(248) 651-8511
(248) 651-5413
Mailing address
340 S MAIN ST, ROCHESTER, MI 48307-2030
(248) 651-8511
(248) 651-5413
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301001923
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2041541
PK
—
05
—
2531863
—
MI
Enumeration date
06/08/2006
Last updated
08/29/2018
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