Organization
JANS DISC PHCY III
Active
Other names
JANS SAV MOR DISCOUNT PHCY III
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS ROOS (OWNER)
(313) 842-9660
Entity
Organization
Contact information
Practice address
1700 WATERMAN ST, DETROIT, MI 48209-2022
(313) 842-9660
(313) 842-9660
Mailing address
PO BOX 79001, DETROIT, MI 48279-0002
(248) 348-1570
(248) 348-4316
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301008556
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2369216
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/26/2006
Last updated
08/01/2011
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