Organization
NOTTTINGHAM PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRENDRA GAIDHANE (PRESIDENT)
(313) 885-3363
Entity
Organization
Contact information
Practice address
15800 E WARREN AVE, DETROIT, MI 48224-3218
(313) 885-3363
(313) 885-3357
Mailing address
15800 E WARREN AVE, DETROIT, MI 48224-3218
(313) 885-3363
(313) 885-3357
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301005956
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730209743
PK
—
05
—
1730209743
—
MI
05
—
2352184
—
MI
Enumeration date
03/31/2007
Last updated
06/16/2018
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