Organization
GST PHARMACY LLC
Active
Other names
Jordan's Discount Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE JONES (OWNER/PHARMACY MANAGER)
(313) 704-5335
Entity
Organization
Contact information
Practice address
13205 DEXTER AVE, DETROIT, MI 48238-3328
(313) 931-3301
(313) 931-3304
Mailing address
13205 DEXTER AVE, DETROIT, MI 48238-3328
(313) 931-3301
(313) 931-3304
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009773
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2376691
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/28/2012
Last updated
04/30/2012
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