Organization
JANS DISC PHCY III
Active
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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